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PEY1 |
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EFFECTS OF PILOCARPINE ON
QUALITY OF LIFE OF THAI PATIENTS WITH GLAUCOMA
Tripop S1, Pratheepawanit N1,
Asawaphureekorn S1, Anutangkoon W2, Inthayung S1,
1Khon Kaen University, Khon Kaen, Thailand, 2Khon
Kaen Hospital, Khon Kaen, Thailand
OBJECTIVE:
Due to collective evidence of pilocarpine interfering with patients’ activities
and reducing compliance, it is considered a third
line drug and reserved when the first and second
line drugs have failed. Pilocarpine is, however,
more commonly used in Thailand’s general hospitals
partly due to its availability as one of a two
group A (generally available) topical drugs for
treating glaucoma on the Thai national essential
drug list. This study examines the effects of
pilocarpine on health related quality of life (HRQOL)
of Thai glaucoma patients. METHODS:
Glaucoma
patients were interviewed using the Thai Visual
Function Questionnaire 28, consisting of 28 items
in 11 domains, ranging from 0 to 100 with higher
domain scores indicating better QOL. This
questionnaire has good reliability, with
Cronbach’s alpha above 0.7 in all domains. The
validity was established using visual acuity (VA)
and visual field (VF). Multivariate analysis using
linear regression was conducted. RESULTS:
Of 367
patients recruited, 218 were female (59.4%), the
mean age was 61 years (range 18-86). Patients
using pilocarpine (N=67) had significantly lower
visual function, education, and income than those
without pilocarpine (N=242). Univariate analysis
shows that patients using pilocarpine had
significantly lower HRQOL scores in all domains.
After adjusting for patients characteristics (age,
sex), disease (VF, VA, duration of disease, other
eye diseases), and treatment (surgery, number of
drugs, frequency of administration), patients
using pilocarpine showed significantly lower HRQOL
scores in distance activities (beta = -13.03),
social (beta = -13.72), mental (beta = -16.29),
dependency (beta = -21.22), color vision (beta =
-16.04), and peripheral vision domains (beta = -
12.90). CONCLUSIONS:
Pilocarpine was associated
with a significant decline in HRQOL scores of up
to 21 points. Adjustment of the national essential
drug list to make more drugs avialable in group A
for glaucoma treatment could be warranted in
Thailand. |
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