(174) Real-World Glaucoma Prescription Adherence Patterns in Medicare Fee-For-Service Patients with Comorbid Dry Eye Disease

Background: : Open-angle glaucoma (OAG) is a chronic degenerative disease that can lead to progressive vision loss if untreated. Patient adherence to glaucoma medications is critical in preserving vision. Dry eye disease could impact adherence to glaucoma medications, potentially worsening outcomes.

Objective: : This study aimed to identify open-angle glaucoma OAG prescription adherence patterns among patients with dry eye disease (DED).

Methods: : 100% Medicare FFS Parts A/B/D claims (January 2016-June 2022) were used to identify OAG patients ≥65 years with incident DED. Patients with more than one diagnosis or prescription for DED within 6-months of the OAG diagnosis or treatment during January 2017-June 2020 were included in the study sample. Index date was the earliest DED diagnosis or treatment during the 6-month period following OAG identification. Patients were continuously enrolled for a 12-month pre-and 24-month post-index period. Patients were excluded if they had any other diagnosed forms of glaucoma, a DED procedure, or pre-index diagnosis or prescription for DED. Comorbid conditions were identified in the 12-month pre-index period. Medication adherence was described over 2 years using Group-Based Trajectory Modeling (GBTM).

Results: : After applying all the attrition criteria, 98,453 OAG-DED patients were identified. Cataract (35%) and neovascular age-related macular degeneration (12%) were the most common ocular comorbidities observed. Most patients were females (65%), Caucasian (79%) with mean (SD) age of 78.3 (8.7). Of the full sample, 66,097 (67.1%) patients had one or more OAG prescriptions within 90 days of index and were therefore used in GBTM modeling. The GBTM identified five distinct adherence patterns. 12% of OAG-DED patients were highly adherent (mean 2-year PDC=93%), 15% were partially adherent (PDC=70%), 26% had plateauing adherence (PDC=55%), 10% had rapid decline (PDC=34%), and 37% were non-adherent (PDC=17%). OAG prescription adherence varied in patients with overall PDC of 66.4%.

Conclusions: : Only 12% patients with DED were adherent and approximately 15% were partially adherent to their OAG prescription medication through 2 years of follow-up. A significant proportion of OAG-DED patients (73%) had declining adherence to their OAG prescription medications over the 2-year period. Significant variation exists in OAG medication adherence for patients with comorbid dry eye, showing decline in all groups over the two-year period.

Sponsorship:: Bausch and Lomb Americas Inc.