Home' Australian Pharmacist : Australian Pharmacist August 2013 Contents Australian Pharmacist August 2013 I ©Pharmaceutical Society of Australia Ltd. 17
BE OUR GUEST
checks and family
By Geoff Pollard, National Executive Officer of Glaucoma Australia
This year marks 25 years since the founding of Glaucoma Australia, a national
not-for-profit patient association dedicated to its mission 'to minimise sight
disability from glaucoma'.
Glaucoma is a group of eye diseases
that damage the optic nerve that
carries messages of sight from the
eye to the brain. This leads to loss of
vision, especially if not detected early,
and treated appropriately. Glaucoma
can occur at any age; however the risk
increases significantly as you grow older.
Approximately 300,000 Australians
have some form of glaucoma, but with
our ageing population, prevalence is
predicted to increase by 80% by 2025.1
Most cases are only detected after some
permanent loss of vision has occurred
and ongoing treatment is currently the
only effective means of halting, or at
least slowing glaucoma's progression.
Approximately 38,000 Australians aged
40 or over have vision loss or blindness
directly caused by glaucoma.2
Pharmacists can make a difference to the
health outcomes of those with glaucoma
and ocular hypertension as their unique
position in the treatment 'value chain'
enables them to discuss aspects of detection
and treatment unavailable to other health
professionals at such regular frequency.
Pharmacists can do three main things
to help improve glaucoma detection
rates (which are currently about 50%1),
treatment adherence and perseverance
rates (currently less than 50% after
12 months3) and the health outcomes
of those with glaucoma (5% of vision
loss and 11% of blindness is caused
by glaucoma in Australians aged
40 and over2).
The mainstay of glaucoma treatment
is reducing intraocular pressure (IOP),
usually by regular instillation of eye
drops.4 Like all chronic, asymptomatic
conditions, adherence to an eye drop
regimen is low. Australian PBS data
reported at the World Glaucoma
Congress in 2011 showed that glaucoma
medication persistence was 56% by
six months and 48% by 12 months.3
Reviewing eye drop usage with those
with glaucoma is a critical action to
encourage patients to stay on therapy.
Patients who understand why they
are taking medication increase their
ownership of treatment, which acts as an
incentive to continue. When a pharmacist
also demonstrates how to administer
eye drops this maximises involvement
and likewise increases persistence.
Patients should be advised to contact
Glaucoma Australia for information,
drop technique training and to acquire
a drop aide relevant to their therapy. An
ongoing subscription to Glaucoma News
is another reminder of the importance of
continued treatment to achieve the best
Follow up eye checks
Everyone with glaucoma should
undertake follow up examinations, to
ensure the treatment is effective and to
detect any progression in visual field loss.
Those with a tendency to 'set or forget'
can be reminded that staying on (the
original) treatment may not be a desirable
course of action for long term benefit.
This may be especially true for those
who have multiple repeat prescriptions
written by their GP, rather than re-visiting
their eye health provider. Likewise,
those who have stopped treatment can
be re-assessed to understand if this has
been to their detriment.
Family history discussions
The second highest risk (after high IOP)
is having a positive family history of
glaucoma.4 Advising glaucoma sufferers
to ensure their immediate and other
family members undergo a simple check
of their optic nerves is sight saving
advice. Having an immediate relative
with glaucoma increases up to 10 times
the risk of having glaucoma themselves
compared with the general population.4
Early detection of glaucoma is vital as lost
vision cannot be recovered.
Apart from the professional satisfaction
pharmacists receive from knowing their
actions can result in a better health
outcome for patients, there are financial
incentives, e.g. MedsCheck available to
assist. Glaucoma Australia is developing
a 'tool kit' to assist pharmacists to
undertake the suggested activities to
improve the lot of those with glaucoma --
watch this space.
More information is available from
Glaucoma Australia at:
• Tel: (02) 9906 6640
• Email: firstname.lastname@example.org
• Website: www.glaucoma.org.au
1. Tunnel Vision: The economic impact of Primary Open Angle
Glaucoma. Centre for Eye Research Australia, 2008.
2. Clear focus: The economic impact of Vision Loss in Australia in
2009. Vision 2020 Australia, 2010.
3. Healey P, et al. Loss to follow-up may be reason for poor
glaucoma medication adherence. Poster: World Glaucoma
Congress Paris, 2011.
4. NHMRC Guidelines for the Screening, Prognosis, Diagnosis,
Management and Prevention of Glaucoma, 2010.
Commonwealth of Australia, 2010.
'Reviewing eye drop
usage with those with
glaucoma is a critical
action to encourage
patients to stay
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