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    Tracking treatment adherence in newly diagnosed open-angle glaucoma

    Claims data point to significant gap between diagnosis, medical/surgical therapies

    Dr. SchwartzA significant number of patients (17%) remained untreated 4 years after their initial open-angle glaucoma (OAG) diagnosis, according to U.S. claims data that follow the prescription of IOP-lowering medications and performance of glaucoma procedures.

    “For this patient population, IOP-lowering eye drops are the most common initial therapy for OAG,” said Gail F. Schwartz, MD. “The availability of ophthalmic fixed combinations has simplified topical dosing regimens for many patients.

    More: Managing ocular surface disease in patients with glaucoma

    “For selected patients, laser trabeculoplasty is frequently an alternative first-line treatment,” added Dr. Schwartz, who is in private practice and assistant professor, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore.

    Despite this, there is little known about the treatment numbers and their sequence and timing used to manage these patients. Having this information available would facilitate more accurate assessment of the patient burden and the unmet need for innovative therapies, she noted.

    Related: How glucosamine supplements may increase IOP

    Considering the need for specific prescribing data, she and her colleagues conducted a retrospective claims analysis using the Truven Marketscan Commercial Claims and Medicare Supplemental databases that covered July 2007 to December 2014.

    Patients were included if they had a minimum of two diagnoses of OAG 7 or more days apart and within 1 year, with the first diagnosis in 2010; 30 or more months of continuous enrollment before the index diagnosis with no OAG diagnosis or OAG medication (unless with an accompanying pre-index ocular hypertension diagnosis); and 48 or more months of continuous enrollment after the index diagnosis.

    During the 4-year study period, investigators evaluated the use of glaucoma medications and the procedures performed, the time from diagnosis to first therapy with medication or laser trabeculoplasty, the sequence of therapies implemented, and the use of adjunctive medications after laser trabeculoplasty.

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    The glaucoma procedures included laser trabeculoplasty, trabeculectomy, implantation of glaucoma drainage device, and a small number of minimally invasive glaucoma surgeries. Further analysis of the surgical procedures is planned.

    Study results

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