Relationship of Neighborhood Socioeconomic Deprivation with Glaucoma Severity and Medication Adherence in Veterans.

PRCIS: In a cohort of 200 veterans with glaucoma, neighborhood socioeconomic deprivation was not significantly associated with disease severity or medication adherence. These findings suggest that the integrated Veterans Health Administration system may mitigate traditional socioeconomic barriers to glaucoma care. PURPOSE: To evaluate the association of neighborhood socioeconomic disadvantage, measured by the Area Deprivation Index, with glaucoma severity and medication adherence in Veterans Health Administration patients. PATIENTS AND METHODS: This study was a secondary data analysis of 200 veterans (100 intervention and 100 control) from the Medication Adherence in Glaucoma to Improve Care randomized controlled trial. Baseline demographics, clinical variables, and 6-month smart-bottle adherence were linked retrospectively to national Area Deprivation Index percentiles corresponding to the time of trial randomization. The primary outcomes were the associations of Area Deprivation Index with disease severity and medication adherence. The secondary outcomes were the associations between Area Deprivation Index and demographic/socioeconomic variables. RESULTS: Area Deprivation Index did not significantly correlate with glaucoma severity (P=0.69). In the control arm, Area Deprivation Index was not correlated with mean weekly medication adherence (P=0.98). There was no interaction between Area Deprivation Index and intervention status regarding mean weekly medication adherence. Lower Area Deprivation Index (less deprivation) was observed among married participants (P=0.003), White participants (P<0.001), urban residents (P<0.001), older participants (P=0.03), and those with higher income (P=0.002). There was no significant difference in Area Deprivation Index based on sex (P=0.24) or employment status (P=0.17). CONCLUSIONS: In this veteran cohort, neighborhood socioeconomic deprivation was not associated with glaucoma severity or medication adherence. These findings suggest that the integrated Veterans Health Administration system may help mitigate socioeconomic barriers in glaucoma care. Larger multicenter studies are recommended to clarify how neighborhood deprivation and health system structure influence glaucoma outcomes.