{
  "abstract": "Background/Objectives: We aimed to evaluate nonadherence to topical glaucoma therapy and identify risk factors for repeated prescription fulfillment failure in a large national population-based cohort. Methods: The electronic medical records from a large health maintenance organization were retrospectively reviewed for all patients aged 18 years or older with a diagnosis of glaucoma from 2000 to 2023. Data on patients who had purchased at least one anti-glaucoma medication were retrieved. Compliance was defined as prescription fulfillment within predefined expiration windows of 1, 2, and 3 months. Repeated nonadherence was defined as three unfulfilled prescriptions within a 3-month expiration window. Multivariable Cox proportional hazards models were used to identify risk factors for repeated failure. Results: Among 40,200 treated patients, ≥80% cumulative prescription fulfillment was achieved in 80.3% of the population under a 3-month expiration definition. Under a strict 1-month definition, the incidence rate of the third compliance failure was 335 per 1000 person-years. In multivariable Cox analysis, obesity (HR 1.37, 95% CI 1.29–1.45) and current smoking (HR 1.07, 95% CI 1.04–1.11) were independently associated with increased risk of repeated failure. Older age (≥70 years: HR 0.73, 95% CI 0.62–0.87) and higher baseline intraocular pressure (≥25 mmHg: HR 0.65, 95% CI 0.61–0.68) were associated with reduced risk. Initiation with prostaglandin analogs was associated with lower hazard compared with alpha-2 adrenergic agonists (HR 0.53, 95% CI 0.49–0.57), whereas treatment alterations (≥3 changes) were associated with increased hazard (HR 1.64, 95% CI 1.39–1.95). Conclusions: Repeated nonadherence to topical glaucoma therapy is common and is associated with identifiable behavioral and treatment-related factors. Recognition of patients at elevated risk may support targeted strategies to enhance long-term treatment stability.",
  "abstract_shown": true,
  "affiliations": [
    "FOKUS AUGE Ophthalmology Clinic, 83022 Rosenheim, Germany",
    "Department of Military Medicine, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9190500, Israel",
    "Department of Ophthalmology, Rabin Medical Center–Beilinson Hospital, Petach Tikva 4941492, Israel",
    "Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel",
    "Kahn Sagol Maccabi (KSM) Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv 6812509, Israel",
    "Laboratory of Eye Research, Felsenstein Medical Research Center, Rabin Medical Center, Petach Tikva 4941492, Israel"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Tal Corina Sela",
      "orcid": "0000-0001-8077-7749"
    },
    {
      "affs": [
        1
      ],
      "name": "Yuval Kozlov",
      "orcid": "0000-0002-8089-9663"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Noa Geffen"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Amit Meshi",
      "orcid": "0000-0002-7440-0539"
    },
    {
      "affs": [
        3,
        4
      ],
      "name": "Guy Melamed",
      "orcid": "0000-0002-2918-3424"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Amir Sternfeld",
      "orcid": "0000-0003-2280-6163"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Yael Sharon",
      "orcid": "0000-0003-1474-218X"
    },
    {
      "affs": [
        2,
        3,
        5
      ],
      "name": "Alon Zahavi",
      "orcid": "0000-0002-9451-5253"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/dc9dtgte57rz7.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15208038",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13705910/?tool=EBI",
  "id": "dc9dtgte57rz7",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://www.mdpi.com/2077-0383/15/20/8038",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2714|Medication Adherence and Compliance"
    ]
  ],
  "openalex": "W7222397242",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13705910/pdf/?tool=EBI",
  "pmcid": "PMC13705910",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/dc9dtgte57rz7.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:00Z",
      "native_id": "10.3390/jcm15208038",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/20/8038"
    },
    {
      "first_seen": "2026-10-30T12:21:45Z",
      "native_id": "PMC:PMC13705910",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13705910"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2714|Medication Adherence and Compliance",
      "subfield": "general"
    }
  ],
  "title": "Patterns and Predictors of Repeated Medication Nonadherence in Glaucoma: A Population-Based Study",
  "title_text": "Patterns and Predictors of Repeated Medication Nonadherence in Glaucoma: A Population-Based Study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:45Z",
  "url": "https://research.draconitic.com/paper/dc9dtgte57rz7",
  "venue": "Journal of Clinical Medicine",
  "versions": []
}