A Study of the Association Between Patterns of Eye Drop Prescription and Medication Usage in Glaucoma Subjects

Abstract

Patients with glaucoma who used eye drops incorrectly were routinely prescribed additional bottles of eye drops. Ophthalmologists should determine whether patients who request an unusual number of eye drops are using the eye drops correctly.

Drop instillation and glaucoma

“…Results of studies using self-report and objectively assessed eye drop technique have both found high rates of incorrect use (Tables 2 and 4). Patients seem fairly willing to admit that they incorrectly perform eye drop instillation [17,18,20,34]. However, self-report may still be less reliable than more objective measures.…”

“…Contaminating the bottle by touching the eye or face was the most frequently missed step. Reported rates of contaminating the bottle in eight different studies ranged from 18.2 [26] to 80% (Table 3) [22,26,17,19,13,23,11 ⬛ ,5,15,9,25,20,14,20]. Two other studies reported separate estimates for touching multiple sites with the bottle; Sleath et al [15] found that 34% of patients touched the eye or eyelash and 52% touched the face, whereas Tatham et al [9] found that 15.3% touched the eye and 27.1% touched the eyelid or lashes.…”

“…The number of patients missing this step in seven different studies ranged from 11.3 [26] to 60.6% [23]. Missing the eye occurred less frequently, but was still a significant problem, with 6.8 [18] to 37.3% of patients experiencing this problem [20]. Missing the eye had consequences in the sense that it was correlated with more bottles used, which could cause patients to experience more cost-related barriers to adherence [20].…”

“…Missing the eye occurred less frequently, but was still a significant problem, with 6.8 [18] to 37.3% of patients experiencing this problem [20]. Missing the eye had consequences in the sense that it was correlated with more bottles used, which could cause patients to experience more cost-related barriers to adherence [20]. In addition to contaminating the bottle, instilling a single drop, and missing the eye, the study by Ikeda et al [25] also measured several other steps with direct observation and found that only 41% washed their hands before instillation, 60% did not close their eyes after instillation, and 70% did not compress the nasolacrimal region after instillation.…”

Efficiency, safety, and patient preference of switching from dorzolamide 1%/timolol 0.5% to brinzolamide 1%/timolol 0.5% while maintaining the prostaglandin F2α analog

“…Fixed combination therapy has an advantage with respect to patient adherence in subjects with glaucoma by decreasing the number of eye bottles required. 1 , 2 The effectiveness of this treatment has been shown to be equal to or greater than that of combination therapy. 3 – 8 Carbonic anhydrase inhibitor and beta-blocker fixed combination therapies are now available in two types: dorzolamide 2% or 1%/timolol 0.5% and brinzolamide 1%/timolol 0.5%.…”