OVERVIEW

The medical management of glaucoma relies primarily on the administration of topical ocular medications. Unfortunately, nonadherence to prescribed treatments has proven to be a significant obstacle to effective glaucoma management. An extensive body of research has been, and is still being, conducted to identify barriers to adherence and devise appropriate methodologies to overcome these barriers. One such example is the Glaucoma Adherence and Persistency Study, which identified several factors that correlated with low adherence, including those related to knowledge deficits, the learning pattern of the patients, and socioeconomic factors, such as the affordability of the medication or simple logistics. In addition, it is critical that ophthalmologists are able to detect and assess the degree of nonadherence, as well as improve doctor-patient communication. Detecting nonadherence requires tact and knowledge of patients’ behavior—techniques that are not stressed in medical school. By learning how to elicit information about nonadherence, appropriately identify the barriers, and tactfully address them, ophthalmologist may be able to improve patient adherence and prevent patients from losing sight.

TARGET AUDIENCE

This activity has been designed to meet the educational needs of ophthalmologists who wish to learn more about enhancing adherence to topical glaucoma medications. No prerequisites required.

GUEST EDITOR

David S. Friedman, MD, PhD
Professor
The Wilmer Eye Institute
The Johns Hopkins University School of Medicine
Baltimore, Maryland

FACULTY

Donald L. Budenz, MD, MPH
Professor of Ophthalmology, Epidemiology and Public Health
Bascom Palmer Eye Institute
Miller School of Medicine
University of Miami
Miami, Florida

Steven R. Hahn, MD
Professor of Clinical Medicine
Instructor of Psychiatry
Albert Einstein College of Medicine of Yeshiva University
Bronx, New York
Jacobi Medical Center
Bronx, New York

James C. Tsai, MD, MBA
Chief of Ophthalmology, Yale-New Haven Hospital
Robert R. Young Professor and Chairman
Department of Ophthalmology and Visual Science
Yale University School of Medicine
Yale Eye Center
New Haven, Connecticut

LEARNING OBJECTIVES

At the conclusion of this activity, participants should be able to:
  • Assess the magnitude of nonadherence issues in glaucoma.
  • Identify the barriers to adherence in patients with glaucoma.
  • Recognize strategies to maximize adherence to glaucoma medications.
The Johns Hopkins University School of Medicine takes responsibility for the content, quality, and scientific integrity of this CME activity.

CME INFORMATION

Accreditation Statement —The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The estimated time to complete this educational activity: 2.5 hours.

Release date: November 15, 2009. Expiration date: November 15, 2011.

Credit Designation Statement — The Johns Hopkins University School of Medicine designates this educational activity for a maximum of 2.5 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Full Disclosure Policy Affecting CME Activities — As a provider accredited by the Accreditation Council for Continuing Medical Education (ACCME), it is the policy of The Johns Hopkins University School of Medicine to require the disclosure of the existence of any significant financial interest or any other relationship a faculty member or a sponsor has with the manufacturer(s) of any commercial product(s) discussed in an educational presentation. The Guest Editor and Participating Faculty reported the following:

David S. Friedman, MD, PhD
Consultant: Pfizer Inc.
Other Financial or Material Support: Zeiss-Meditec Instrument Loan.

Donald L. Budenz, MD, MPH
Consultant: Alcon Laboratories, Inc, and Santen Pharmaceutical.
Lecturer: Alcon Laboratories, Inc, and Pfizer Inc.
Financial Support for Research: Allergan, Inc, Carl Zeiss Meditec, Pfizer Inc., and New World Medical.

Steven R. Hahn, MD
Consultant/Advisor: Astellas Pharma Inc, AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Ortho-McNeil Pharmaceuticals, Inc, and Pfizer Inc.
Lecturer: GlaxoSmithKline, Ortho-McNeil Pharmaceuticals, Inc, and Pfizer Inc.

James C. Tsai, MD, MBA Consultant: Allergan, Inc, Inspire Pharmaceuticals, Inc, Merck & Co, Inc, and Pfizer Inc.
Financial Support for Research: Alcon Laboratories, Inc., Allergan, Inc., Inspire Pharmaceuticals, Inc., Merck & Co., Inc., Pfizer Inc., and National Institutes of Health.
National Eye Institute and a Departmental Challenge Grant from Research to Prevent Blindness, Inc.

Mary Gabb, MS
Equity Owner: Pfizer Inc. and Wyeth.
Financial Support: Pfizer Inc.

Notice: All faculty have indicated that they have not referenced unlabeled/unapproved uses of drugs or devices.

Disclaimer — The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of The Johns Hopkins University School of Medicine name implies review of educational format, design, and approach. Please review the complete prescribing information of specific drugs or combinations of drugs, including indications, contraindications, warnings, and adverse effects, before administering pharmacologic therapy to patients.

Internet CME Policy — The Office of Continuing Medical Education (CME) at The Johns Hopkins University School of Medicine is committed to protect the privacy of its members and customers. Johns Hopkins University School of Medicine CME maintains its Internet site as an information resource and service for physicians, other health professionals, and the public. Continuing Medical Education at The Johns Hopkins University School of Medicine will keep your personal and credit information confidential when you participate in a CME Internet-based activity. Your information will never be given to anyone outside of The Johns Hopkins University School of Medicine’s CME activity. CME collects only the information necessary to provide you with the services that you request.

Instructions
Please complete the brief pre-test before continuing with this supplement. Although completing the pre-test is not mandatory for receiving credit, it will provide an accurate means to assess the effectiveness of the course material. After reading this supplement, participants may receive credit by completing the CME test, evaluation, and receiving a score of 70% or higher.




     
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