Physicians’ treatment decisions, patient persistence, and interruptions in the continuous use of prostaglandin therapy in glaucoma

AbstractBackground:Uninterrupted use of ocular hypotensive medication by glaucoma patients is important to prevent vision loss, but medication persistence is poor. Efficacy and tolerability influence physicians’ decisions and patient persistence, and differences between medications may impact persistence.Objective:To examine differences in physician’s decisions to continue, switch, or discontinue therapy across three prostaglandin analogs (PGAs) latanoprost, bimatoprost, and travoprost using claims data supplemented by evaluation of physicians’ charted therapeutic decisions.Methods:A year of pharmacy claims data for 6271 patients with a first (index) fill between 5/1/2001 and 11/30/2004 for PGA monotherapy were classified as ‘persistent’, ‘switched’, ‘restarted’, or ‘discontinued’ with initial PGA use. An analysis of index therapy continuation during the first 2 years reflected chart reviews for 223 patients with PGA monotherapy as the index prescription.Results:Ten percent of patients had uninterrupted u...