PMID- 33171476
OWN - NLM
STAT- MEDLINE
DCOM- 20211206
LR  - 20220716
IS  - 1423-0259 (Electronic)
IS  - 0030-3747 (Print)
IS  - 0030-3747 (Linking)
VI  - 64
IP  - 3
DP  - 2021
TI  - The Minimal Clinically Important Difference in Glaucoma Medication Adherence: 
      Interviews of Glaucoma Experts.
PG  - 524-528
LID - 10.1159/000512924 [doi]
AB  - Poor adherence to glaucoma medications is associated with progressive vision 
      loss. While many interventions have sought to increase glaucoma medication 
      adherence, the amount by which adherence must increase to have a clinically 
      significant effect remains unknown. To generate a hypothesized minimal clinically 
      important difference (MCID) for glaucoma medication adherence, we conducted 
      interviews with glaucoma experts. Semi-structured interviews were conducted with 
      members of the American Glaucoma Society. MCID was defined in 2 ways: (1) the 
      incremental increase in the average percentage of eye drops a patient takes at 
      roughly the correct time and (2) the incremental increase in the proportion of a 
      patient population who attain good adherence. Good adherence was defined as 
      taking more than 80% of drops at approximately the prescribed dose time. Expert 
      opinions on the MCID for glaucoma medication adherence and open-ended responses 
      were recorded through field notes. Twenty-five experts were interviewed. They 
      estimated the MCID for average individual adherence levels as 17.7% (95% CI: 
      14.6, 20.8). Experts estimated the MCID for the proportion of patients in a 
      practice who attain good adherence (defined as >80% of eye drops taken as 
      prescribed) as 18.5% (95% CI: 15.6, 21.5). The most common identified themes were 
      that the MCID should take into account the cost of the intervention and the 
      burden to the ophthalmologist and to the practice, where experts thought that 
      more costly interventions or those that required more physician time should have 
      larger MCIDs. Based on expert opinion, we hypothesized that the MCID for glaucoma 
      medication adherence is between 15 and 20%. However, the MCID for a given 
      intervention must take into account several factors, including intervention cost 
      and physician burden. This hypothesis may facilitate the design and 
      implementation of future studies to objectively determine an MCID for glaucoma 
      medication adherence.
CI  - (c) 2020 S. Karger AG, Basel.
FAU - Kolli, Ajay
AU  - Kolli A
AD  - University of Michigan Medical School, Ann Arbor, Michigan, USA.
FAU - Daniel-Wayman, Shelby
AU  - Daniel-Wayman S
AD  - Department of Ophthalmology and Visual Sciences, University of Michigan, Ann 
      Arbor, Michigan, USA.
FAU - Newman-Casey, Paula Anne
AU  - Newman-Casey PA
AD  - Department of Ophthalmology and Visual Sciences, University of Michigan, Ann 
      Arbor, Michigan, USA, panewman@med.umich.edu.
LA  - eng
GR  - K23 EY025320/EY/NEI NIH HHS/United States
GR  - R01 EY031337/EY/NEI NIH HHS/United States
PT  - News
DEP - 20201110
PL  - Switzerland
TA  - Ophthalmic Res
JT  - Ophthalmic research
JID - 0267442
RN  - 0 (Ophthalmic Solutions)
SB  - IM
MH  - *Glaucoma/drug therapy
MH  - Humans
MH  - Medication Adherence
MH  - *Minimal Clinically Important Difference
MH  - Ophthalmic Solutions
PMC - PMC9088219
MID - NIHMS1795402
OTO - NOTNLM
OT  - Adherence
OT  - Glaucoma
OT  - Minimal clinically important difference
COIS- Conflict of Interest Statement The authors have no conflicts of interest to 
      disclose.
EDAT- 2020/11/11 06:00
MHDA- 2021/12/15 06:00
PMCR- 2022/05/10
CRDT- 2020/11/10 20:15
PHST- 2020/07/31 00:00 [received]
PHST- 2020/10/23 00:00 [accepted]
PHST- 2020/11/11 06:00 [pubmed]
PHST- 2021/12/15 06:00 [medline]
PHST- 2020/11/10 20:15 [entrez]
PHST- 2022/05/10 00:00 [pmc-release]
AID - 000512924 [pii]
AID - 10.1159/000512924 [doi]
PST - ppublish
SO  - Ophthalmic Res. 2021;64(3):524-528. doi: 10.1159/000512924. Epub 2020 Nov 10.