Researchers undertook a study in response to evidence suggesting the COVID-19 pandemic is disrupting medication adherence and other health behaviors. The objective was to determine the pandemic’s effect, if any, on ocular hypotensive medication adherence and to identify the factors associated with those changes. The results were published in October 2021 in the journal Ophthalmology.

The cohort study drew 79 primary open-angle glaucoma patients with an average age of 71 years from a preexisting longitudinal National Institutes of Health–funded study. Included patients used prescription ocular hypotensive medication and had an adherence record covering the full 300-day study period, which began October 16, 2019, and ended August 10, 2020. The investigation was designed as a controlled interrupted time series, with the interruption on March 13, 2020 — the day the national emergency was declared in the United States.

Researchers implemented a segmented regression analysis to derive adherence slopes before and after the interruption and compared them using the Davies test to express as a percentage the number of taken doses divided by doses prescribed. They also evaluated the change in adherence considering clinical, psychosocial, and demographic factors. The analysis revealed a breakpoint 28 days following the pandemic’s declaration, after which adherence rates went from 0.006% per day to -0.04% per day.

Researchers concluded that ocular hypotensive medication adherence dropped during the COVID-19 pandemic. They noted a significant positive association with patient resilience — defined as the process of positive adaptation to adversity — as measured on the Connor-Davidson scale. The adherence decline “was significantly worse in Black patients (median, IQR: 80.6%, 36.2%) compared with White patients (median, IQR: 97.2%, 8.7%),” the authors reported. They hypothesized that one of the pandemic’s side effects may be increases in vision loss well after the virus has been eradicated.