DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20181645

Prescribing trends of anti glaucoma medication usage in treatment naive patients of primary open angle glaucoma in a tertiary care hospital in Eastern India

Aditi Maitra, Shashwat Bhattacharyya, Shatavisha Mukherjee, Nikhil Era, Sambuddha Ghosh, Santanu Kumar Tripathi

Abstract


Background: Primary open angle glaucoma remains a high magnitude healthcare problem due to its prevalence and chronicity. The real world scenario of anti glaucoma medical therapy needs periodical auditing as far as drug prescriptions are concerned for formulation of treatment guidelines. Few studies from India have taken a longitudinal approach in this respect. This study was undertaken to identify such lacunae.

Methods: This was an open label, prospective, observational study. Each treatment naive patient was followed up for a period of 6 months, where their prescriptions were scanned for the type of the anti glaucoma medications, total number of medications, route of administration, their duration of use and their frequency of dosage and change in medications if any, in each visits.

Results: A gradual shift from monotherapy towards combination therapy was observed. Overall averages for prescriptions were topped by monotherapy at 44.25 followed by fixed dose combinations at 38.25, and then combination-polytherapy at 36 and the least number of prescriptions were for concurrent polytherapy at 17.5. Amongst all monotherapy agents, beta blockers were the most frequently prescribed drugs at baseline but their share of prescriptions was almost halved at the end of our study. The prostaglandin analogs on the other hand saw an upsurge in prescriptions from their baseline to the end of this study. Prostaglandin analogs andbeta blockers as fixed dose combination was a popular prescription over the entire study duration.

Conclusions: Prescribing trends were remarkable for the shift from primary monotherapy towards fixed dose combinations as the study concluded. The decline in the number of beta blocker prescriptions and a rise in prostaglandin analog prescriptions is a testament to their better effectiveness and tolerability. The future of open angle glaucoma pharmacotherapy lies in prescribing more efficacious drugs either in monotherapy or in fixed combinations.


Keywords


Anti-glaucoma medications, Glaucoma management, Prescribing trends, Primary open angle glaucoma

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References


Quigley HA, Broman AT. The number of people with glaucoma worldwide in 2010 and 2020. The British J Ophthalmol. 2006;90(3):262-7.

George R, Ve RS, Vijaya L. Glaucoma in India: estimated burden of disease. J Glaucoma. 2010;19:391-7.

Nayak B, Gupta S, Kumar G, Dada T, Gupta V, Sihota R. Socioeconomics of long-term glaucoma therapy in India. Ind J Ophthalmol. 2015;63(1):20-4.

Sambhara D, Aref AA. Glaucoma management: relative value and place in therapy of available drug treatments. Therapeutic Advances in Chronic Disease. 2014;5(1):30-43.

Paul C, Sengupta S, Choudhury S, Banerjee S, Sleath BL. Prevalence of glaucoma in Eastern India: The Hooghly River Glaucoma Study. Ind J Ophthalmol. 2016;64(8):578-83.

Lin JC. The use of ocular hypotensive drugs for glaucoma treatment: changing trend in Taiwan from 1997 to 2007. J Glaucoma. 2015;24(5):364-71.

Connor, A J, and S G Fraser. “Glaucoma Prescribing Trends in England 2000 to 2012.” Eye 28.7. 2014:863-9.

De Natale R, Draghi E, Dorigo MT. How prostaglandins have changed the medical approach to glaucoma and its costs: an observational study of 2228 patients treated with glaucoma medications. Acta Ophthalmol Scand. 2004;82(4):393-6.

Yadav AK, Patel V. Drug use in primary open angle glaucoma: A prospective study at a tertiary care teaching hospital. Ind J Pharmacol. 2013;45(2):117.

Rai S, Khilji S, Rao LG, Hegde P, Gonsalves SR, Shanbhag TV. Prescribing pattern and adverse events of drugs used in patients with primary open-angle glaucoma (POAG) attending a tertiary care hospital: Retrospective study. National J Physiol Pharmacy and Pharmacol. 2017;7(2):189-93.