Cost of Medical Treatment for Primary Open-Angle Glaucoma in Relation to Patients’ Income and Its Impact on the Prognosis of the Disease, in Bouaké University Hospital
Introduction: Medical treatment for POAG is
continuous and lifelong treatment. The aim of this study was
to evaluate the relationship between the cost of this treatment and patients’ income and the impact of
this relationship on treatment compliance. Materials
and Methods: Prospective cross-sectional study with a descriptive aim
covering sociodemographic data, average incomes, and direct and indirect
costs of treatment of 57 patients followed for POAG during the period from
January 1, 2012, to December 31, 2016 (5 years). Results: The patients
were aged 25 to 77 years (mean = 54.4 years) with a male predominance (sex
ratio = 1.5). Retirees were the most represented (26.32%), followed by workers in the informal sector
(14.04%) and housewives (12.28%). Patients who had an annual income less
than or equal to 900,000 CFA francs (€1370.83) per year represented 56.14% and
those who did not have health coverage represented 57.89%. The treatment was
monotherapy (64.91%), dual therapy (31.58%) or triple therapy (3.05%) and the
average ratio of “annual cost of treatment to annual income” was 0.56 with for
maximum 2.23 and 0.02 as minimum. Patients who considered the cost of treatment
unbearable for their income represented 78.95%. Conclusion: Prevention
of blindness due to glaucoma requires early detection but also the
establishment of health coverage mechanisms to improve compliance with medical
treatment. In addition, consideration should be given to the development of
glaucoma surgery in our country, the indication of which could be the first
intention in certain patients, considering for those patients, the geographical
and financial accessibility of medical treatment.
References
[1]
European Glaucoma Society (2008) Terminology and Guidelines for Glaucoma. 3rd Edition, European Glaucoma Society, Savona.
[2]
Bechetoille, A. (1987) Glaucomes. Jappenard, Angers, 221, 589-596.
[3]
European Glaucoma Society (2003) Terminology and Guidelines for Glaucoma (European Guidelines). 2nd Edition, Editrice DOGMA, Savona.
[4]
Camras, C.B., Toris, C.B. and Tamesis, R.R. (1999) Efficacy and Adverse Effects of Medications Used in the Treatment of Glaucoma. Drugs & Aging, 15, 377-388. https://doi.org/10.2165/00002512-199915050-00005
[5]
Bremond, J. and Geledan, A. (1981) Dictionnaire Economique Et Social. Hatier, Paris.
[6]
Moukouri, E. and Moli, M.C. (1991) Le GPAO en milieu Camerounais A propos de 61cas observés à l’hôpital central de Yaoundé—Médecine d’Afrique noire. Médecine d’Afrique Noire, 38, 8-9.
[7]
Bron, A., Nordmann, J.P. and Baudouin, C. (2003) Glaucome et hypertonie oculaire: importance de la pression intraoculaire cible dans la prise en charge thérapeutique en France. Journal Français d’Ophtalmologie, 26, 895-903.
[8]
Ouertani, A., Zhioua, R., Trabelsi, A., et al. (1995) Prévalence du glaucome à angle ouvert dans une commune de Tunis. Journal Français d’Ophtalmologie, 18, 178-182.
[9]
Ahnoux-Zabsonre, A., Keita, C., Safede, K. and Tanoe, A. (1998) Prévalence du glaucome chronique primitif à angle ouvert en Côte d’Ivoire. Journal Français d’Ophtalmologie, 21, 643-647.
[10]
Sounouvou, I., Tchabi, S., Monteiro, S., Yehouessi, L., Doutetien, C., et al. (2012) Thérapeutique du glaucome primitif à angle ouvert à Cotonou: à propos de 224 cas. Journal Français d’Ophtalmologie, 35, 100-105. https://doi.org/10.1016/j.jfo.2011.02.015
[11]
Demailly, P.H. (1989) Traitement actuel du glaucome primitif à angle ouvert. Société Française d’Ophtalmologie. Masson, Paris.
[12]
Mac Donald, A.E. (1965) Causes of Blindness in Canada: An Analysis of 24.605 Cases Registered with the Canadian National Institute for the Blind. Canadian Medical Association Journal, 92, 264-279.
[13]
Ouattara, Y. (2016) Glaucoma Medical Treatment: Impact on Quality of Life and Patient Compliance. Jacobs Jouroal of Ophthalmology, 2, 16.
[14]
Données sur les comptes nationaux de la Banque mondiale et fichiers de données sur les comptes nationaux de l’OCDE (organisation de coopération et de développement économique 2015.
[15]
Negrel, A.D. (2007) Glaucome: concentrons-nous sur le pôle postérieur. Nos patients y gagneront-Revu de santé communautaire, 4, 1-3.
[16]
Van buskirk, E.M. and Cioffi, G.A. (1992) Glaucomatous Optic Neuropathy. American Journal of Ophthalmology, 113, 447-452. https://doi.org/10.1016/S0002-9394(14)76171-9
[17]
Rouland, J.F. (2004) Initial Medical Treatment: Beta-Blockers or Prostaglandins? The Beta-Blocker Is the Swiss Army Knife of the Glaucoma Physician. Journal Français d’Ophtalmologie, 27, 716-717. https://doi.org/10.1016/S0181-5512(04)96204-3
[18]
Wane, A.M., Ndiaye, M.R., Ndiaye, P.A., Ba, E.A., et al. (2003) Compliance of Medical Treatment in Primitive Glaucoma Open Angle. Journal Français d’Ophtalmologie, 26, 1039-1044.
[19]
Rakkaa, A., Aitmoulay, L., Moutawakil, A., Harouch, M., Rachid, R., El Belhadji, M., et al. (2003) Glaucome primitif à angle ouvert: quel coût au Maroc? Journal de 1a Société Marocaine d’Ophtalmologie, 15-16, 42-44.
