alexa Adherence and Persistence with Glaucoma Therapy: Brimonidine/Timolol versus Dorzolamide/Timolol and Various Two-Bottle Combinations | OMICS International
ISSN: 2155-9570

Journal of Clinical & Experimental Ophthalmology
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Research Article

Adherence and Persistence with Glaucoma Therapy: Brimonidine/Timolol versus Dorzolamide/Timolol and Various Two-Bottle Combinations

Gail F. Schwartz1,2*, Caroline Burk3, Teresa Bennett4 and Vaishali D. Patel5
1Greater Baltimore Medical Center, Baltimore, MD, USA
2Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA
3Health Outcomes Consultant, Laguna Beach, CA, USA
4Source Healthcare Analytics, Phoenix, AZ, USA
5Allergan, Inc., Irvine, CA, USA
Corresponding Author : Gail F. Schwartz, MD
GBMC Physicians Pavilion East,
6565 N. Charles St, Suite 302
Baltimore, MD 21204, USA
Tel: (410) 825-9225
Fax: (410) 825-9229
E-mail: [email protected]
Received August 16, 2012; Accepted October 10, 2012; Published October 17, 2012
Citation: Schwartz GF, Burk C, Bennett T, Patel VD (2012) Adherence and Persistence with Glaucoma Therapy: Brimonidine/Timolol versus Dorzolamide/Timolol and Various Two-Bottle Combinations. J Clin Exp Ophthalmol 3:248. doi:10.4172/2155-9570.1000248
Copyright: © 2012 Schwartz GF, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Abstract

Purpose: Patients with glaucoma often require multiple topical medications to reach target intraocular pressure. This database analysis examined persistence and adherence in patients’ prescribed fixed-combination brimonidine/ timolol, fixed-combination dorzolamide/timolol, or various commonly used two-bottle combinations. Participants: Glaucoma patients (ICD-9 code: 365.xx; n=7883) from the Source Healthcare Analytics Source® Lx database with an index prescription for fixed-combination brimonidine/timolol, fixed-combination dorzolamide/timolol, or various commonly used two-bottle combinations during the 6-month qualifying period (January 2008–June 2008), but not the 12 months before, were included. Methods: In this retrospective prescription database analysis, adherence and persistence for fixedcombination brimonidine/timolol were compared to fixed-combination dorzolamide/timolol and various commonly used two-bottle combinations. The two-bottle arms were: β-blocker+brimonidine; β-blocker+carbonic anhydrase inhibitor; β-blocker+prostaglandin analogue; carbonic anhydrase inhibitor+brimonidine; carbonic anhydrase inhibitor+prostaglandin analogue; and prostaglandin analogue+brimonidine. Main outcome measures: Persistence for brimonidine/timolol was compared with each of the comparators using Kaplan-Meier survival analysis for 12 months after the index prescription. Adherence was assessed using the medication possession ratio. Results: Kaplan-Meier analyses found that a significantly greater proportion of patients remained on treatment with brimonidine/timolol (34.9%) compared with each of the other treatments (13.4%–20.8%; p<0.0001) at the end of the study period. In addition, the 12-month medication possession ratio was significantly higher for brimonidine/ timolol (42.7%) than for each of the two-bottle arms (23.3%–34.9%; p<0.0001 for all comparisons). The medication possession ratio for brimonidine/timolol was also slightly, but significantly, higher than that for dorzolamide/timolol (40.6%; p=0.0208). Conclusions: Persistence and adherence are higher with a fixed-combination single bottle of brimonidine/timolol than with fixed-combination dorzolamide/timolol and commonly used two-bottle combinations.

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