Home' Australian Pharmacist : Australian Pharmacist August 2014 Contents Australian Pharmacist August 2014 I ©Pharmaceutical Society of Australia Ltd.
Glaucoma describes a group of eye
diseases in which there is progressive
damage to the optic nerve characterised
by specific structural abnormalities
of optic nerve head and associated
patterns of visual field loss.1 Glaucoma
can occur at any age; however the risk
increases significantly with advancing
age. Approximately 300,000 Australians
have some form of glaucoma, but with
an ageing population the prevalence is
predicted to increase by 80% by 2025.2
Most cases are only detected after some
permanent loss of vision has occurred.
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.3 Whilst an individual's
risk of progressive and sight-threatening
glaucoma cannot be predicted with
precision, it is clear that early treatment
reduces the number of individuals who will
develop visual field defects.1
Pharmacists can make an important
difference to the health outcomes of
those with glaucoma and their families,
as they review aspects of glaucoma
detection and treatment that are
unlikely to be discussed by other health
professionals at such regular intervals.
Glaucoma Australia offers glaucoma
education to pharmacists and is
providing resources, including Improving
Adherence in Glaucoma -- A manual for
pharmacists to assist pharmacists to
undertake that worthwhile task.
Pharmacists can improve glaucoma
treatment adherence and perseverance
rates. Presently, less than 50% of patients
with glaucoma continue to use their
medication after one year.4
The mainstay of treatment for glaucoma
is to reduce intra-ocular pressure, usually
by regular instillation of eye drops.1 Similar
to the treatment for other chronic, largely
asymptomatic conditions adherence to
an eye drop regimen is low. Australian
prescribing data, reported at the World
Glaucoma Congress (2011) showed
glaucoma medication persistence was
56% at six months and reduced further to
48% at one year.4
Evidence supports a patient-centric self-
management approach that facilitates
optimal adherence to the medication
management plan.1 Pharmacists who
continually emphasise to patients the
need for adherence and persistence with
medication management strategies, and
provide practical assistance (such as eye
drop technique training) are undertaking
a critical action that encourages patients
to stay on their medication, and use,
their eye drops in the manner prescribed.
Patients who understand why they are
using medicines increase their ownership
Advising those with glaucoma 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
compared with the general population.1
GA recommends all pharmacists actively
offer this advice to their glaucoma patients.
The pharmacists' role
Glaucoma Australia in association with UTS:
Pharmacy, part of the Graduate School
of Health at The University of Technology
Sydney has developed Improving Adherence
in Glaucoma -- A Manual for Pharmacists.
This manual provides pharmacists with
an understanding of glaucoma and raises
awareness of the issues affecting patient
adherence to glaucoma medications.
Furthermore it aims to help pharmacists
develop strategies to identify and address
adherence issues, in order to achieve
optimal patient outcomes.
Pharmacists are well-positioned to play a
primary role in improving adherence to
glaucoma medications.5 Moreover, literature
supports the efficacy of pharmacist-led
interventions in improving the detection
and management of chronic conditions as
well as improving patient adherence.6,7
This toolkit outlines the role of pharmacists
in improving patient adherence to glaucoma
medications. Specifically, how pharmacists
can detect and assess glaucoma medication
non-adherence and implement patient
adherence strategies into everyday practice.
It includes an overview of the financial
incentives available to assist pharmacists
undertaking glaucoma adherence education
An informative webinar and a
Pharmaceutical Society of Australia online
learning module will be made available
during 2014--15 to assist pharmacists to
undertake glaucoma adherence education.
The webinar will be held on Tuesday 28
October. In the meantime, patients can be
advised to contact Glaucoma Australia for
further education and support.
For further information, please contact:
• Glaucoma Australia: (02) 9906 6640 or
• Pharmaceutical Society of Australia
1300 369 772 email@example.com
1. NHMRC Guidelines for the Screening, Prognosis, Diagnosis,
Management and Prevention of Glaucoma, 2010.
Commonwealth of Australia, 2010.
2. Tunnel Vision: The economic impact of Primary Open Angle
Glaucoma. Centre for Eye Research Australia, 2008.
3. Clear focus: The economic impact of Vision Loss in Australia
in 2009. Vision 2020 Australia, 2010.
4. Healey P, et al. Loss to follow-up may be reason for poor
glaucoma medication adherence. Poster: World Glaucoma
Congress Paris, 2011.
5. Sabate E. Adherence to long-term therapies: Evidence for action
[Internet]. Switzerland: World Health Organisation; 2003
6. Tsuyuki RT, et al. A randomised trial of the effect of community
pharmacist intervention on cholesterol risk management: the
study of cardiovascular risk intervention by pharmacists (SCRIP).
Archives of Internal Medicine. 2002.
7. Lee JK, Grace KA, Taylor AJ. Effect of a pharmacy care
program on medication adherence and persistence,
blood pressure, and low-density lipoprotein cholesterol: a
randomised controlled trial. JAMA. 2006.
Geo Pollard is National Executive Officer of
Adherence matters for
patients and pharmacists
By Geoff Pollard
Glaucoma Australia's (GA) mission is to 'minimise sight disability from
glaucoma.' It provides education and resources to assist pharmacists to
discuss glaucoma medication adherence.
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