The glaucoma is a chronic degenerative disease, characterised by progressive damage to the optic nerve, which leads to irreversible loss of vision and is the second leading cause of blindness in the world.
Geriatric patients often do not adhere correctly to glaucoma treatment, due to the difficulty of applying eye drops and topical drugs on the one hand, and the ease with which they forget to administer them on the other. on the other. In these cases, pharmacists can play their part in preventing aggravations and improving clinical outcomes of therapy in patients by acting as caregiver or providing assistance and information.
The problem of therapeutic adherence in glaucoma
The World Health Organisation (WHO) defines adherence as 'the extent to which a person's behaviour in taking medication, following a diet, and/or changing lifestyle corresponds to recommendations agreed upon with a health professional'. Poor treatment adherence is a worldwide problem that undermines the effectiveness of treatment, quality of life and health economics.
Treatment adherence in the case of glaucoma drugs is associated with a number of factors, which have been classified into four groups: patient-related adherence, drug-related adherence, provider-related adherence and situational/environmental factors.
In the management of glaucoma, poor adherence to treatment is one of the main problems due to adverse outcomes and higher eye care costs. Furthermore, if appropriate, effective and successful treatment is provided, blindness secondary to glaucoma is preventable. Indeed, the primary goal of glaucoma therapy is to prevent progressive vision loss by lowering intraocular pressure. This goal can be achieved through the administration of ophthalmic drugs, laser treatment, surgery or a combination of these modalities.
Topical drugs are the first line of treatment to reduce intraocular pressure. Therefore, long-term adherence to these drugs is crucial to limit disease progression. Patients with poor adherence to topical glaucoma drugs have been shown to have worse outcomes, with a higher rate of vision loss and higher healthcare costs.
The role of the pharmacist
Since pharmacists have direct and regular contact with patients and have access to medication dispensing data, they can play a key role in advising patients and improving therapeutic adherence. The pharmacist's task, in collaboration with prescribing physicians, should therefore be to monitor the therapeutic adherence of glaucoma patients and to support them through education on the correct administration of medication.
In a recent study, the change in treatment adherence of glaucoma patients following pharmacist-guided intervention was analysed. In this research, after 6 months, a significant change was found in the group of patients followed by pharmacists, who went from low to high adherence. Furthermore, the number of patients whose intraocular pressure was in the safe range increased significantly among those who were followed by pharmacists. Finally, the follow-up have significantly improved knowledge and theawareness patients about their pathology.
The results of this study have, therefore, shown that educational assistance and support in treatment by the pharmacist is an effective method of improving adherence to glaucoma medication, especially in geriatric patients, who showed better adherence and a consequent marked improvement in intraocular pressure control.
Bibliography:
Dr. Carmelo Chines
Direttore responsabile
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