Dry eye disease associated with Sjögren’s syndrome: Cost of treatment a factor

Patients with dry eye disease associated with Sjögren’s syndrome worried about the ability to complete daily tasks and the prospects of reduced vision or blindness,1 according to research by Evan Michaelov, MD, from the Department of Ophthalmology, Schulich School of Medicine and Dentistry, London, Canada, and colleagues.

They also reported non-adherence to dry eye therapy related to cost.

Dry eye disease that is associated with Sjögren’s syndrome often is more severe than that not related to the syndrome. The symptoms include ocular irritation, vision disturbances, and difficulty performing visual tasks, the investigators pointed out, and they noted the importance of patient engagement in their treatment plan.

“Self-care in dry eye disease includes involves daily, proactive instillation of ocular lubricants, topical anti-inflammatory agents, intake of dietary supplements as well as environmental and behavioral modifications,2” they stated.

Michaelov and colleagues conducted a cross-sectional study in which an anonymous electronically distributed survey was sent to members of the Southwestern Ontario chapter of the Sjögren’s Society of Canada, and the survey then was given to patients with a diagnosis of Sjögren’s syndrome. The goal was to identify factors that affected adherence to treatment of dry eye disease in this patient population.

The patients who completed the questionnaire reported have difficulty with visual tasks, such as driving, and diminished enjoyment in daily activities resulting from dry eye symptoms. About 80% and 50%, respectively, were concerned about reduced quality of life and blindness.

“The most common reasons for non-adherence were cost of therapy and forgetting to instill drops. Drop rationing to reduce cost of therapy was endorsed by 83% of respondents,” the investigators said. “Only 3% of respondents had private insurance for non-prescription agents required to treat DED.”

About 25% of the participants also admitted to not telling their eye care provider about non-adherence with treatment. Age was found to contribute significantly to not instilling drops.

According to the investigators, this is the first study to report on the financial burden experienced by patients with dry eye associated with Sjögren’s syndrome in Canada.

“This paper identified strategies used by patients to reduce the cost of therapy and its impact on adherence to treatment,” they concluded. “Patients may be reluctant to disclose challenges regarding adherence to dry eye disease therapy, as well as fears of worsening quality of life.”

References

• Michaelov E, McKenna C, Ibrahim P, et al. Sjögren’s syndrome associated dry eye: impact on daily living and adherence to therapy. J Clin Med 2022;11:2809; https://doi.org/10.3390/jcm11102809
• McDonald M, Patel D, Keith M, Snedecor D. Economic and humanistic burden of dry eye disease in Europe, North America, and Asia: a systematic literature review. Ocul Surf 2016;14:144-67.