무보존제 도졸라마이드-티몰롤 복합제제의 미사용 용기 확인을 통한 녹내장 환자의 순응도 평가
Adherence to Preservative-Free Dorzolamide/Timolol Fixed Combination Assessed by Counting the Unused Single-Dose Units
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목적: 무보존제 도졸라마이드-티몰롤 복합제제를 처방 받은 원발개방각녹내장 환자들에서 사용하고 남은 낱개 포장용기 개수를 이용하여 순응도를 알아보고자 하였다. 대상과 방법: 처음 원발개방각녹내장을 진단 받은 환자 34명을 대상으로 무보존제 도졸라마이드-티몰롤 복합제제(낱개 포장용기)를처방하여 2주 후 외래 내원 시 잔여 용기를 가지고 오게 하였다. 2차 방문 시 환자에게 점안 시작 후 본인의 안약 사용률이 어느정도인지에 대한 설문 조사를 먼저 실시하고, 환자가 지참하고 온 남은 안약의 개수를 확인하였다. 안압하강제를 처음으로 사용한후 다음 외래 내원 시까지의 예상되는 안약 사용 개수와 실제 남은 안약의 개수를 확인하여 측정 순응도(%)를 조사하였고, 이를 통해응답 순응도와의 관계를 알아보았다. 결과: 설문 조사를 통한 환자들의 자가 응답 순응도 결과 93.5% (29명/31명)의 환자들이 90% 이상 안압하강제를 사용하였다고 응답했으며, 나머지 2명도 80-90%의 순응도를 보였다. 그러나 측정 순응도는 9명(29.0%)의 환자들에서 90% 미만으로, 설문지에 의한응답 순응도와 차이를 보였으며 이 중 3명(9.7%)은 측정 순응도가 60% 이하로 나타났다. 4명(12.9%)의 환자들의 측정 순응도는 100% 를 초과하였다(1명, 196%; 3명, 107-132%). 결론: 사용하지 않은 낱개 포장용기 개수 확인을 통해 환자의 진술에 근거한 순응도 평가는 실제 순응도와 차이가 있음을 알 수 있었다. 보존제가 없어 낱개로 포장되는 녹내장 점안액은 잔여 개수 확인을 통하여 실제 순응도를 확인하는 데 유용하다.
Abstract
Purpose: To investigate the actual adherence to treatment with preservative-free dorzolamide-timolol fixed combination (DTFC) eyedrops of primary open-angle glaucoma (POAG) patients by counting the number of unused single-dose units of DTFC. Methods: This study included 34 POAG patients newly prescribed with preservative-free DTFC eyedrops (formulated in single- dose units). The enrolled patients were asked to bring the unused DTFC units on their next visit after 2 weeks of treatment with DTFC. On their second visit, they were asked to complete a questionnaire regarding the self-reported adherence and the number of unused DTFC single-dose units was counted. The actual adherence (%) was calculated by dividing the expected number of used DTFC units by the actual number of used DTFC units. The correlation between the self-reported adherence and the measured adherence was assessed. Results: Twenty-nine (93.5%) patients answered they adhered to the medication by more than 90% and 2 (6.5%) answered they instilled the eyedrops at 80-90% of the dosing schedule. However, after counting the unused DTFC single-dose units, 9 (29.0%) patients showed an actual adherence of ＜90%. Moreover, the actual adherence of 3 (9.7%) patients was ＜60%. Unexpectedly, 4 (12.9%) patients showed the actual adherence exceeding 100% (196%, 1 patient; 107-132%, 3 patients). Conclusions: We demonstrated a large difference between the self-reported and the actual adherence to treatment by counting the unused single-dose units of eyedrops. Preservative-free topical anti-glaucoma medications (formulated in single-dose units) provide clinicians an opportunity to assess the actual adherence of glaucoma patients by counting the unused units of eyedrops.
참고문헌 (14)
- Kingman S., "Glaucoma is second leading cause of blindness globally", Bull World Health Organ, 82, pp.887~888 (2004)
- Kass MA., "The Ocular Hypertension Treatment Study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma", Arch Ophthalmol, 120, pp.701~713 (2002)
- Collaborative Normal-Tension Glaucoma Study Group., "The effectiveness of intraocular pressure reduction in the treatment of normal-tension glaucoma", Am J Ophthalmol, 126, pp.498~505 (1998)
- Friedman DS., "An evidence-based assessment of risk factors for the progression of ocular hypertension and glaucoma", Am J Ophthalmol, 138(3 Suppl), pp.S19~S31 (2004)
- Osterberg L., "Adherence to medication", N Engl J Med, 353, pp.487~497 (2005)
- Ashburn FS Jr., "Compliance with ocular therapy", Surv Ophthalmol, 24, pp.237~248 (1980)
- DiMatteo MR., "Variations in patients' adherence to medical recommendations : a quantitative review of 50 years of research", Med Care, 42, pp.200~209 (2004)
- Schwartz GF., "Adherence and persistence with glaucoma therapy", Surv Ophthalmol, 53(Suppl1), pp.S57~S68 (2008)
- Kist K., "Automated static perimetry" (1998), Mosby
- Feuer WJ., "Clinical decisions in glaucoma" (1993), Mosby
- Beckers HJ., "Side effects of commonly used glaucoma medications : comparison of tolerability, chance of discontinuation, and patient satisfaction", Graefes Arch Clin Exp Ophthalmol, 246, pp.1485~1490 (2008)
- Hahn SR., "Patient-centered communication to assess and enhance patient adherence to glaucoma medication", Ophthalmology, 116(11 Suppl), pp.S37~S42 (2009)
- Ahn DH., "Factors affecting compliance with prescribed eyedrops for glaucoma", J Korean Ophthalmol Soc, 39, pp.2145~2151 (1998)
- Park MH., "Noncompliance with glaucoma medication in Korean patients : a multicenter qualitative study", Jpn J Ophthalmol, 57, pp.47~56 (2013)