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Article
April 1985

Compliance and Prognosis in Glaucoma

Arch Ophthalmol. 1985;103(4):504. doi:10.1001/archopht.1985.01050040046014

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Abstract

Poor compliance is an important limiting factor in the medical management of many chronic diseases. Yet, we have little information about defaulting from treatment regimens in ophthalmology. In part, this reflects methodologic problems of measuring compliance with topical ophthalmic medication. The recent development of eyedrop medication monitors allows us, for the first time, to make accurate and objective measurements of defaulting in ophthalmology.1-3 The initial studies have been restricted to pilocarpine and indicate a high rate of defaulting in terms of missed doses and inadequate time spacing of doses.4,5

See also p 529.

Good compliance is not an end in itself. The clinician must relate compliance to disease prognosis, especially if he or she is considering vigorous interventions to reduce defaulting. In an article published in this issue of the Archives, Granström6 finds little relationship between compliance with 4% pilocarpine treatment prescribed three times daily and progression

References
1.
Norell SE, Granström P-A, Wassen R:  A medication monitor and fluorescein technique designed to study medication behaviour . Acta Ophthalmol 1980;58:459-467.Article
2.
Yee RD, Hahn PM, Christensen RE:  Medication monitor for ophthalmology . Am J Ophthalmol 1974;78:774-778.
3.
Kass MA, Meltzer DW, Gordon MO:  A miniature compliance monitor for ophthalmology . Arch Ophthalmol 1984;102:1550-1554.Article
4.
Norell SE, Granström P-A:  Self-medication with pilocarpine among outpatients in a glaucoma clinic . Br J Ophthalmol 1980;64:134-141.
5.
Kass MA, Meltzer DW, Gordon MO:  The compliance factor , in Drance SM, Neufeld AH (eds): Glaucoma: Applied Pharmacology in Medical Treatment . New York, Grune & Stratton Inc, 1984, p 537-568.
6.
Granström P-A:  Progression of visual field defects in glaucoma: Relation to compliance with pilocarpine therapy . Arch Ophthalmol 1985;103:529-531.Article
7.
Holmen C, Krakau CET:  Visual field decay in normal subjects and in cases of chronic glaucoma . Graefes Arch Klin Exp Ophthalmol 1980;213:291-299.Article
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