Queen's University Belfast

Academic Institute

Economic and Social Research Council

Yes

073

Glaucoma is one of the most common preventable forms of blindness both globally and in the UK. It occurs when raised pressure within the eye causes irreversible damage to the optic nerve. Routine eye examinations are the primary means of early detection through disclosure of raised intraocular pressures, even though no symptoms may be present. Progression of glaucoma towards serious sight loss can be slowed considerably by a treatment regime of daily eye drops which reduce intraocular pressures. However, persistence with treatment over extended periods is poor; a recent large study in the US indicated that only 60% of new patients had continued treatment over a 12 month period and only 10% had no interruptions in treatment during the entire period. Poor adherence to and persistence with glaucoma medication has been associated with a range of factors related to the patient, healthcare provider, type of medication and environment but existing studies of treatment persistence have focused primarily on the influences of medication type or frequency of interactions with healthcare providers. We aim to investigate the influence of patient characteristics and especially social context (family structure, deprivation etc.) on glaucoma treatment persistence. We will link a detailed set of contextual information at the individual, family and area levels drawn from the 2011 Census with records of filled prescriptions drawn from the Northern Ireland Enhanced Prescribing Database. Identifying factors associated with low glaucoma treatment persistence is an initial step towards designing interventions to increase persistence in high risk groups.

Glaucoma is the second most common causes of blindness in the UK. Caring for those declared blind incurs substantial costs which may be avoided if disease progression is halted by regular use of eye drops. Identifying factors which influence persistence with glaucoma treatment may indicate areas in which interventions to increase persistence would be beneficial in terms of both patient welfare and economic value. Should this project identify novel risk factors or groups at elevated risk it is hoped that the findings would form the basis of a larger study to investigate potential interventions at both the patient and practitioner levels to increase treatment persistence.

01/09/2017

TRE