Use of Ocular Hypotensive Medications in Portugal: PEM Study: A Cross-sectional Nationwide Analysis

Purpose: There is scarcity of European data about intraocular pressure (IOP)-lowering prescribing patterns. We aimed to describe and discuss the nationwide prescription of these medications in Portugal. Materials and Methods: This was a cross-sectional study including all patients who were prescribed at least 1 IOP-lowering medication in 2015 in Portugal. All ocular hypotensive drug prescriptions were gathered from the common electronic drug prescription system used by all hospitals and clinics in Portugal. Demographic data, medications prescribed (number and formulation), physician specialty, and costs of medications were provided in an encrypted and anonymous form. Statistical analyses were performed using STATA. Results: A total of 231,634 participants (57% women) were prescribed IOP-lowering medications in 2015, representing 4.0% of the population older than 40 years of age and 2.2% of the Portuguese total population. Mean age was 72 +/- 13 years. Topical IOP-lowering therapy accounted for a total of 26 million euros (M(sic)) in costs, shared between patients and the national health system. General practitioners (GPs) accounted for 52% of all prescriptions. The most prescribed drugs were latanoprost (28%), timolol/dorzolamide (19%), and brimonidine (14%). Among all, 72% of patients were on monotherapy. Compared with ophthalmologists, GPs presented qualitative differences in their prescription pattern, such as a lower proportion of unit dose prescription. Conclusion: A significant percentage of the Portuguese population is currently treated with IOP-lowering medications, and the majority of them are on monotherapy. Although GPs are responsible for most prescriptions, their prescription pattern is different from that of ophthalmologists. This nationwide study revealed prescription patterns and disclosed the burden of the disease in terms of its medical management.