Factors Associated with Poor Eye Drop Administration Technique and the Role of Patient Education among Hong Kong Elderly Population

Abstract

Objectives. To identify the risk factors for poor eye drop application technique in treatment-naïve subjects and to assess if patient education can benefit these subjects. Methods. Chinese subjects above 60 years were recruited. Questionnaires, including Barthel index; Lawton’s instrumental activities of daily living (ADL); Fatigue, Resistance, Ambulation, Illnesses, and Loss of Weight (FRAIL) scale; and Montreal Cognitive Assessment (MoCA), were used to correlate with eye drop application technique (before and after patient education) using Spearman correlation analysis. A multiple linear regression was conducted to determine the predictors of successful administration technique and the improvement of technique after education. Results. The data from 26 subjects (mean age 72) were analyzed. Eye drop instillation technique score improved from 5.42 at baseline to 7.33 after clear instructions. FRAIL score was an independent predictor of baseline score (p=0.003), as well as the improvement after patient education (p=0.012). Age, sex, education level, visual acuity, Barthel index, MoCA, and ADL score were not correlated with eye drop instillation technique, before nor after patient education. Discussion. In patients with poor functional status as reflected by FRAIL score, eye drop application is prone to be ineffective. Education with step-by-step instructions could effectively improve the success of eye drop application.

Research and correlation analysis on the dripper contamination of carteolol hydrochloride eye drops

“…During the use of eye drops, 78/244 (32%) patients had a contact history with the eyelids, eyelashes, or conjunctiva, which was consistent with the results reported in other literature (20,21). Previous studies showed that the poor infusion capability of glaucoma patients was related to age, limited education, and poor hands-on flexibility (22,23). In the current study, the contamination rate was not associated with the age and education level of glaucoma patients.…”

“…However, unfortunately, the experience of such surgery did not improve the health awareness of patients, and there was no statistical difference in the contamination rate of drippers between the operation group and the non-operation group. Choy et al (23) reported that the infusion success rate can be significantly improved after eye drop skills training in a group of elderly patients. Thus, some specially-designed eye drop bottles (24,25) or special eye drop aid systems (26) may play a vital role in addition to improving the infusion skills of eye drops and improving the safety awareness of hand hygiene.…”

Adherence to Topical Medication in Patients with Inflammatory Eye Disease

“…Improper drop instillation has been cited as an important feature in non-adherence to glaucoma medications. [11][12][13][14][15][16][17] Although we did not directly observe patients instilling their medication, as only 42% stated they had received instruction on how to do so and 26% of patients reported an insufficient time interval (< five minutes) between consecutive medications, then it is reasonable to assume some patients would be doing this incorrectly.…”

“…1 Previous studies have demonstrated that patient adherence to topical medication in conditions, such as glaucoma can be poor and appears influenced by a number of factors, such as understanding of disease, [2][3][4] rationale of treatment, 2,5,6 having a simplified treatment regimen, [7][8][9][10] ease of drop instillation and whether they are dispensed in single use containers or multiple-use bottles. [11][12][13][14][15][16][17] In the ophthalmic literature there is very little information on adherence in inflammatory eye disease. 18 We wished to evaluate adherence to topical medication in patients with inflammatory eye disease in a tertiary Eye Centre setting and to identify factors that may influence this.…”

Overcoming barriers to patient adherence: the case for developing innovative drug delivery systems

“…Using topical eye drops is generally considered to be the most convenient and safe approach for treating ocular conditions, including glaucoma, and generally leads to the highest patient acceptability. However, as many as nine out of ten patients are unable to properly instil eye drops 147 , 148 , leading to an increased risk of under-medication or over-medication and, potentially, resulting in poor outcomes and unnecessarily high treatment costs. Long-acting DDSs, including clinically available injectable depots, refillable devices and in situ-forming hydrogels, are promising strategies to improve medication adherence, mainly because they minimize the need for frequent drug administration.…”