The effect of the Thai “Eye Drop Guide” on success rate of eye drop self-instillation by glaucoma patients

Abstract

Background: Noncompliance can mislead clinicians regarding the efficacy of therapy and result in more aggressive, but inappropriate treatment. Improper techniques used for eye drop instillation frequently occurs in chronic glaucoma patients. The Thai Eye Drop Guide (EDG) device has been developed to ensure precise instillation. However, whether the EDG is more effective than the traditional technique when careful instructions for both techniques are given is still unknown. Objective: To compare success rates of eye drop self-instillation by chronic glaucoma patients using a traditional technique and the EDG when careful instructions for both are given. Methods: Fifty-nine chronic glaucoma patients were instructed to instill eye drops using the EDG or a traditional technique in a randomized sequence. A two week practice period was assigned before groups were crossed-over. The instillation performance was VDO recorded after each practice period. Three criteria of success: time taken to instill an eye drop into the eye; instillation of only one drop; and without the bottle tip touching lids, lashes, periocular tissues, or the other hand, were scored by three independent readers from video-records. The readers were blinded to the sequence to which the patients were randomized. Results: There were no significant differences in success rates between the EDG and traditional technique (61.0% and 66.1% respectively, p = 0.607) and the number of drops dispensed per application (median of 1 drop in both groups, p = 0.89). The time taken to instill eye drops with the EDG was significantly longer than using the traditional technique (median of 19 and 9 s respectively, p < 0.001). Older age (p = 0.049, OR 4.23) and more education (p = 0.025, OR 0.19) were found to be significantly associated with failure of the EDG. Conclusion: EDG is not more effective than a traditional technique in terms of improving dispensing accuracy and decreasing the drops dispensed per application even when careful instructions are given. The results suggest that, if good instructions are provided, experienced glaucoma patients can improve their eye drop instillation performance.

<p>Patients’ Experience of Using Eye Drop Guide Device to Aid Self-Administration of Glaucoma Medications</p>

“…The process of eye drop administration with the EDG was found to be almost twice as long compared to the Traditional technique in a primary study. 12 The greater number of eye drops being used, the longer it will take each administration time. Also handling eye drop bottles together with the EDG is not effortless if they are not fitted.…”

“…In our previous study, we demonstrated that the success rates of eye drop self-instillation were not statistically significant between EDG device and the traditional technique when the patients were properly trained with each technique. 12 After the study, the devices were given to all participants. The decision to continue using the device were as per their preference.…”

Orbital Exenteration: a series of cases

“…It is known that the elderly presented over time a worsening of fine motor coordination, and therefore they are a group that can benefit the most from the facial support devices. (10) Sakiyalak et al (11) conducted a prospective, cross-linked and randomized study comparing the proportion of successful self-instillation of eye drops in patients with glaucoma who used or not a facial support device. The device was named "Thai Eye Drop Guide" (patent 6555, Mahidol University, 9/2/ 2011).…”