According to emerging research, the coronavirus disease 2019 (COVID-19) pandemic is interfering with health behaviors such as medication adherence. For a study, researchers sought to determine if the pandemic influenced adherence to ocular hypotensive treatment and to identify factors that contributed to this shift. They employed a controlled interrupted time series design in the cohort study, with the interruption being the announcement of the COVID-19 pandemic in the United States on March 13, 2020. The 300-day monitoring period, which began on October 16, 2019, and ended on August 10, 2020, was equally spaced. Patients with primary open-angle glaucoma who were participating in an ongoing longitudinal National Institutes of Health-funded research that began before the pandemic’s commencement and had adherence data covering the 300-day period were chosen.
To get the adherence slopes before and after segmentation, investigators used segmented regression analysis using a “slope change after a lag” effect model. They used the Davies test to compare the two slopes. The primary end measure was daily adherence to ocular hypotensive medicine, which was calculated as the number of doses taken divided by the number of doses prescribed, reported as a percentage. Medication Event Monitoring System caps were used to objectively monitor adherence. They investigated the relationships between adherence change and demographic, clinical, and psychological variables.
There were 79 patients in the study (mean age, 71 [standard deviation, 8 years]). Segmented regression found a breakpoint 28 days after the epidemic was declared. The slope after the breakpoint (–0.04%/day) differed considerably from zero (P<0.001) and from the slope before the breakpoint (0.006%/day; P<0.001). Adherence was considerably lower in Black patients (median, IQR: 80.6%, 36.2%) compared to White patients (median, IQR: 97.2%, 8.7%; chi-square, 15.4; P=0.0004). The Connor-Davidson resilience score was shown to have a significant positive relationship with the change in slope between the periods before and after the breakpoint (P=0.002). Adherence to ocular hypotensive treatment deteriorated during the COVID-19 epidemic and appears to be linked to patient resilience. The unintended effect of the epidemic might result in eyesight loss that is not curable.
Reference:www.aaojournal.org/article/S0161-6420(21)00786-7/fulltext
