Self‐application of single‐use eyedrop containers in an elderly population: comparisons with standard eyedrop bottle and with younger patients

Abstract

. Purpose: To test whether patients aged ≥80 years can safely and successfully apply eyedrops from a single‐use eyedrop container without support, and to compare the results with those of younger patients using single‐use containers and older patients using standard eyedrop bottles. Methods: Patients aged ≥80 years who had no physical or mental conditions hindering self‐application of eyedrops and actually did so because of glaucoma or dry eyes were included consecutively in the study group (n = 44) in order to perform self‐application of eyedrops from single‐use eyedrop containers. Patients were observed meticulously by two investigators, who documented practical problems during the procedure in a checklist. In control group A (n = 22), glaucoma or sicca patients aged between 50 and 65 years applied drops from single‐use eyedrop containers; in control group B (n = 28), glaucoma or sicca patients aged ≥80 years used a traditional eyedrop bottle. Results: Successful application of the drops into the conjunctival sac was achieved by 57% in the study group (95% and 89% in control groups A and B, respectively). Scratching of the eyedrop container along the conjunctiva or cornea was observed in 68% of the study group (41% and 61% in control groups A and B, respectively). Frequency of problems during opening and self‐application of single‐use eyedrop containers in the study group showed an inverse correlation to visual acuity in the better eye and previous experience with this kind of eyedrop container. Conclusion: Older patients have massive problems in self‐administering eyedrops from single‐use containers. Factors influencing the success of self‐application may include the patient’s previous experience with this kind of eyedrop container and the patient’s visual acuity.

Eye drop instillation technique in patients with glaucoma

“…In other studies, the incidence of missing the eye when attempting to instil an eye drop has ranged from 6.8 to almost 20%, and the incidence of contaminating the bottle tip has ranged from 20 to over 70%. 14,21 Factors associated with poor technique have also been examined with older age, 15 limited school education, 15,16 and poor vision 16 reported to be of importance. Brown et al 13 found that patients attending private practice were more likely to have a good eye drop instillation technique and suggested that this was because the private patients received better instructions on the use of drops; however, the effect of education on instillation technique was not directly examined.…”

“…For example, a poor technique is more likely in those with poor manual dexterity, poor vision, limited schooling, and older age. 1,15,16 There is, however, little evidence as to whether education regarding how to self-administer eye drops is associated with a better eye drop instillation technique. Lack of education is likely to be a large problem, as when clinicians prescribe eye drops, proper explanation and demonstration of how the eye drops should be used is often neglected.…”

Handling Test of Eye Drop Dispenser—Comparison of Unit-Dose Pipettes with Conventional Eye Drop Bottles

“…In a recent study by Dietlein et al, 15 it was reported that glaucoma or dry eye patients, aged 80 years or older, experienced more difficulty in opening and applying drops from single-dose containers compared with conventional eye drop bottles. Decreased visual acuity as well as lack of experience was significantly correlated with difficulties in the correct instillation of eye drops.…”

“…In the study by Dietlein et al, participants had used eye drop bottles earlier, but only a fraction had previous experience with single-use eye-drop containers (27%-39%). 15 The problems with selfinstillation from the single-dose containers were associated with lack of experience with using them. The authors concluded that there was a training effect involved.…”

“…However, in previous studies it has been suspected that elderly patients may have difficulties in managing single-use dispensers, and the instillation of the eye drops may fail more often compared with conventional eye drop bottles. 14,15 Obviously, this may be due to several factors such as the size and shape of the dispensers and softness of the plastic material. The purpose of this study was to investigate how elderly participants manage unit-dose pipettes in comparison to conventional eye drop bottles.…”