Document Detail


Treatment of glaucoma in clinical practice: four-year results from a patient registry in France.
MedLine Citation:
PMID:  19661825     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To investigate long-term resource consumption and clinical outcome of patients with early primary open-angle glaucoma or ocular hypertension treated with prostaglandins in clinical practice in France.
METHODS: Thirty-four geographically spread specialized hospitals and private practices enrolled consecutive patients receiving, for the first time, a prostaglandin, alone or in combination. The study was based on routine practice and no consultations, examinations, or treatments were mandated by the protocol. Treating physicians recorded each consultation, including all examinations performed, referrals, admissions, and prescriptions. Descriptive analysis of resource consumption and development of intraocular pressure (IOP) and visual fields was performed, for all patients who completed the 4-year follow-up.
RESULTS: The study enrolled 602 patients and 78% completed 4-year follow-up. Mean age was 65 years and mean time since diagnosis was 4 years. Mean IOP was reduced from a baseline of 21.2 mm Hg to 16.5 mm Hg during the first year and remained stable throughout the study. Mean visual fields at baseline were -4.2 mean deviation and stable during the follow-up. Total mean health care costs per patient were €1947, of which medication represented 50%. Over half of the patients (52%) remained on their initial medication during the 4 years. Drug changes were mostly because of inadequate IOP control and the number of treatment switches was significantly related to costs.
CONCLUSIONS: This is the first prospective study of treatment with prostaglandins in clinical practice. The results indicate that many patients with early glaucoma managed primarily with prostaglandins will show very little progression over 4 years. Compared with the mid-90s, costs have not increased despite the higher acquisition cost of prostaglandins, as surgical interventions and medical consultations have decreased.
Authors:
Gisela Kobelt; Brigitte Texier-Richard; Patricia Buchholz; Alain Bron; Jean-Paul Renard; Jean-Francois Rouland; Jean-Philippe Nordmann
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of glaucoma     Volume:  19     ISSN:  1536-481X     ISO Abbreviation:  J. Glaucoma     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-10-11     Completed Date:  2010-12-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9300903     Medline TA:  J Glaucoma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  199-206     Citation Subset:  IM    
Affiliation:
European Health Economics, Speracedes, France. Gisela.kobelt@he-europe.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Amides / economics,  therapeutic use
Antihypertensive Agents / economics*,  therapeutic use
Cloprostenol / analogs & derivatives,  economics,  therapeutic use
Cost-Benefit Analysis
Drug Costs
Female
France
Glaucoma, Open-Angle / drug therapy,  economics*,  physiopathology
Health Care Costs*
Health Resources / utilization
Humans
Intraocular Pressure / drug effects
Male
Middle Aged
Ocular Hypertension / drug therapy,  economics,  physiopathology
Prospective Studies
Prostaglandins F, Synthetic / economics,  therapeutic use
Registries
Chemical
Reg. No./Substance:
0/Amides; 0/Antihypertensive Agents; 0/Prostaglandins F, Synthetic; 0/bimatoprost; 130209-82-4/latanoprost; 157283-68-6/travoprost; 40665-92-7/Cloprostenol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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