Assessing the Societal Burden of Glaucoma Patients With vs. Without Physical or Mental Comorbidities.

Abstract

Background: Glaucoma is a collection of eye diseases that damage the eye’s optic nerve resulting in vision loss and blindness. Treatment for glaucoma is primarily pharmacologic, however, adherence issues with topical medications are problematic. Patients with select comorbid conditions that impact physical or mental function might be most at risk for adherence issues. Objective: Characterize patients with vs. those without select physical or mental comorbidities and estimate differences in healthcare resource use (HCRU), healthcare expenditures and health related quality of life (HRQoL) between the two groups, using Medical Expenditure Panel Survey (MEPS) data. Methods: MEPS data collected between 2003-2014 was aggregated and viewed cross-sectionally using the first year of data for each patient during a two year panel survey. The subgrouping by physical or mental comorbid conditions was done using ICD-9 codes collected by MEPS. Between group comparisons in the outcomes of interest (HCRU, expenditure, HRQoL) were conducted using several different regression analyses. Results: We identified a total of 2,928 glaucoma patients during the 11 years of collected data, including 1,539 who had a comorbid condition labeled as physical or mental. Those with select physical or mental comorbidities had greater unadjusted HCRU and expenditures (all P<0.05), however after adjustment for many possible confounders significant associations did not persist for the majority of individual HCRU or expenditure outcomes. HRQoL as measured by the two component, physical and mental, SF-12 was lower in the with select physical and mental comorbidity subgroup both before and after adjustment for confounding (all P<0.05). Conclusion: Our study displays that glaucoma patients with a physical or mental comorbidity have increased healthcare resource use and expenditure with a lower health-related quality of life compared to those without one, however much, if not all, of this difference is attributable to different baseline characteristics between the two subgroups.