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Hayata E, Suzuki S, Hoshi SI, Sekizawa A, Sagara Y, Ishiwata I, Kitamura T. Trends in Syphilis in Pregnant Women in Japan in 2016 and 2022. Cureus 2024; 16:e56292. [PMID: 38495970 PMCID: PMC10944339 DOI: 10.7759/cureus.56292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2024] [Indexed: 03/19/2024] Open
Abstract
Since 2012, the rate of syphilis infection has increased dramatically in high-income countries including Japan. In this study, we examined the rate of syphilis infection among pregnant women and perinatal outcomes in the syphilis-infected pregnancy in 2022 in Japan, and compared the results with those in 2016. We requested 2,005 obstetric institutes to provide information on syphilis infection in pregnant women who delivered in 2022. A total of 1,346 obstetrical facilities responded with valid information. We compared the results with those in our previous study. The prevalence of syphilis-infected pregnant women was 1/1,215. The incidence of preterm delivery, intrauterine fetal demise and congenital syphilis in surviving neonates in the syphilis-infected pregnancy were 9%, 2% and 7%, respectively. The prevalence of syphilis-infected pregnant women has increased significantly, while the incidence of congenital syphilis seems to have decreased clinically.
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Affiliation(s)
- Eijiro Hayata
- Division of Maternal and Child Health, Japan Association of Obstetricians and Gynecologists, Tokyo, JPN
| | - Shunji Suzuki
- Division of Maternal and Child Health, Japan Association of Obstetricians and Gynecologists, Tokyo, JPN
| | - Shin-Ichi Hoshi
- Division of Maternal and Child Health, Japan Association of Obstetricians and Gynecologists, Tokyo, JPN
| | - Akihiko Sekizawa
- Division of Maternal and Child Health, Japan Association of Obstetricians and Gynecologists, Tokyo, JPN
| | - Yoko Sagara
- Division of Maternal and Child Health, Japan Association of Obstetricians and Gynecologists, Tokyo, JPN
| | - Isamu Ishiwata
- Division of Maternal and Child Health, Japan Association of Obstetricians and Gynecologists, Tokyo, JPN
| | - Tadaichi Kitamura
- Infectious Diseases, Japanese Foundation for Sexual Health Medicine, Tokyo, JPN
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2
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Bott D, Subramanian A, Edgar D, Lawrenson JG, Campbell P. Barriers and enablers to medication adherence in glaucoma: A systematic review of modifiable factors using the Theoretical Domains Framework. Ophthalmic Physiol Opt 2024; 44:96-114. [PMID: 37985237 DOI: 10.1111/opo.13245] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/05/2023] [Accepted: 10/06/2023] [Indexed: 11/22/2023]
Abstract
PURPOSE Nonadherence to medication reduces treatment effectiveness, and in chronic conditions it can significantly reduce health outcomes. In glaucoma, suboptimal adherence can lead to sight loss, which places a greater financial burden on society and reduces patients' quality of life. Interventions to improve adherence have so far had limited success and lack robust theoretical underpinnings. A better understanding of the determinants of medication adherence behaviour is needed in order to develop interventions that can target these factors more effectively. This systematic review aims to identify modifiable barriers and enablers to glaucoma medication adherence and identify factors most likely to influence adherence behaviour. RECENT FINDINGS We searched CINAHL, MEDLINE, PsycINFO, EMBASE, the Cochrane Library and sources of grey literature up to August 2022 for studies reporting determinants of glaucoma medication adherence. Data describing modifiable barriers/enablers to adherence were extracted and analysed using the Theoretical Domains Framework (TDF), a behavioural framework consisting of 14 domains representing theoretical factors that most likely influence behaviour. Data were deductively coded into one of the TDF domains and inductively analysed to generate themes. Key behavioural domains influencing medication adherence were identified by frequency of study coding, level of elaboration and expressed importance. Eighty-three studies were included in the final synthesis. Four key domains influencing glaucoma medication adherence were identified: 'Environmental Context and Resources', 'Knowledge', 'Skills' and 'Memory, Attention and decision processes'. Frequently reported barriers included complex eyedrop regimens, lack of patient understanding of their condition, forgetfulness and difficulties administering eyedrops. Whereas simplified treatments, knowledgeable educated patients and good patient-practitioner relationships were enablers to adherence. SUMMARY We identified multiple barriers and enablers affecting glaucoma medication adherence. Four theoretical domains were found to be key in influencing adherence behaviour. These findings can be used to underpin the development of behaviour change interventions that aim to improve medication adherence.
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Affiliation(s)
- Deborah Bott
- Department of Optometry and Visual Sciences, School of Health and Psychological Sciences, City, University of London, London, UK
| | - Ahalya Subramanian
- Department of Optometry and Visual Sciences, School of Health and Psychological Sciences, City, University of London, London, UK
| | - David Edgar
- Department of Optometry and Visual Sciences, School of Health and Psychological Sciences, City, University of London, London, UK
| | - John G Lawrenson
- Department of Optometry and Visual Sciences, School of Health and Psychological Sciences, City, University of London, London, UK
| | - Peter Campbell
- Department of Optometry and Visual Sciences, School of Health and Psychological Sciences, City, University of London, London, UK
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3
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Pérez-García P, Burgos-Blasco B, Morales-Fernández L, Fernández-Ruiz-Morón A, Gómez-Calleja V, Oribio-Quinto C, Collado-Vincueria I, Garcia-Feijoo J, Martinez-de-la-Casa JM. Prescription trends for preservative free glaucoma medication in a public health system. Eur J Ophthalmol 2024; 34:193-203. [PMID: 37070183 DOI: 10.1177/11206721231170034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
PURPOSE To analyze the prescribing trends over a 7-years period, between 2013 and 2020, in a tertiary hospital (Hospital Clinico San Carlos, Madrid, Spain) and its health area. MATERIAL AND METHODS A retrospective study on the data collected from the information systems, "farm@web" and "Farmadrid", of glaucoma prescriptions in the framework of a public health system (Spanish National Health System) during the last seven years. RESULTS Prostaglandin analogues were the most commonly used drugs in monotherapy during the study period (range: 36.82% - 47.07%). Fixed combinations of topical hypotensives had an upward trend since 2013 (range: 39.99% - 54.21%), becoming the most dispensed drugs in 2020 (48.99%). Preservative-free eye drops (lacking benzalkonium chloride, BAK) have displaced preservative containing topical treatments in all pharmacological groups. In 2013, BAK-preserved eye drops accounted for 91.1% of the total prescriptions, however in 2020 they only accounted for 34.2% of total prescriptions. CONCLUSIONS The results of the present study highlight the current trend to avoid BAK-preserved eye drops for the treatment of glaucoma.
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Affiliation(s)
- Pilar Pérez-García
- Ophthalmology Unit, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), Madrid, Spain
| | - Bárbara Burgos-Blasco
- Ophthalmology Unit, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), Madrid, Spain
| | - Laura Morales-Fernández
- Ophthalmology Unit, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), Madrid, Spain
| | | | - Verónica Gómez-Calleja
- Ophthalmology Unit, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), Madrid, Spain
| | - Carlos Oribio-Quinto
- Ophthalmology Unit, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), Madrid, Spain
| | - Isabel Collado-Vincueria
- Ophthalmology Unit, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), Madrid, Spain
| | - Julian Garcia-Feijoo
- Instituto de Investigaciones Oftalmológicas Ramon Castroviejo, Universidad Complutense de Madrid, Madrid, Spain
- Cooperative Research Network on Age-Related Ocular Disease, and Visual and Life Quality, Instituto de Salud Carlos III, Madrid, Spain
- Ophthalmology Unit, Hospital Clinico San Carlos, Dept. of Ophthalmology and ORL, Faculty of Medicine, Universidad Complutense de Madrid, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), Madrid, Spain
| | - Jose María Martinez-de-la-Casa
- Ophthalmology Unit, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), Madrid, Spain
- Instituto de Investigaciones Oftalmológicas Ramon Castroviejo, Universidad Complutense de Madrid, Madrid, Spain
- Ophthalmology Unit, Hospital Clinico San Carlos, Dept. of Ophthalmology and ORL, Faculty of Medicine, Universidad Complutense de Madrid, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), Madrid, Spain
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Quaranta L, Novella A, Tettamanti M, Pasina L, Weinreb RN, Nobili A. Adherence and Persistence to Medical Therapy in Glaucoma: An Overview. Ophthalmol Ther 2023; 12:2227-2240. [PMID: 37311908 PMCID: PMC10441906 DOI: 10.1007/s40123-023-00730-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 04/28/2023] [Indexed: 06/15/2023] Open
Abstract
Glaucoma is a group of progressive optic neuropathies characterized by loss of retinal ganglion cells and visual field deterioration. Despite the fact that the underlying pathophysiology of glaucoma remains unknown, elevated intraocular pressure (IOP) is a well-established risk factor, and the only factor that can be modified. Robust evidence from epidemiological studies and clinical trials has clearly demonstrated the benefits of IOP control in reducing the risk of glaucoma progression. IOP-lowering therapy by the means of eye drops remains a first-line treatment option. However, like other chronic and asymptomatic conditions, many patients with glaucoma have difficulties in maintaining high rates of adherence persistence to prescribed medications. On average, patients with chronic medical conditions take 30-70% of the prescribed medication doses, and on average 50% discontinue medications in the first months of therapy. The ophthalmic literature shows similarly low rates of adherence to treatment. Indeed, poor adherence is associated with disease progression and increased complication rates, as well as healthcare costs. The present review analyzes and discusses the causes of variability of the adherence to the prescribed drugs. The education of patients about glaucoma and the potential consequences of insufficient adherence and persistence seems fundamental to maximize the probability of treatment success and therefore prevent visual disability to avoid unnecessary healthcare costs.
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Affiliation(s)
| | - Alessio Novella
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Mauro Tettamanti
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Luca Pasina
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Robert N Weinreb
- Viterbi Family Department of Ophthalmology, and Shiley Eye Institute, Hamilton Glaucoma Center, University of California San Diego, La Jolla, CA, USA
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Tash R, Alshugaig R, Mahboob H, Raffa LH, Jamjoom H, Almarzouki N, Bawazeer A. Adherence to Follow-Up and the Related Factors of Paediatric Glaucoma at a Tertiary Care Centre in Western Saudi Arabia. Cureus 2023; 15:e44124. [PMID: 37750134 PMCID: PMC10518214 DOI: 10.7759/cureus.44124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2023] [Indexed: 09/27/2023] Open
Abstract
INTRODUCTION Glaucoma is a main cause of blindness globally. In Saudi Arabia, congenital glaucoma is believed to affect 1 in every 2500 live births. In this study, we identified the adherence and evaluated the factors associated with non-compliance (non-adherence) to recommended follow-up appointments at King Abdulaziz University Hospital, a tertiary centre in Jeddah, Saudi Arabia. METHODS The medical records of paediatric patients diagnosed with glaucoma between 2009 and April 2022 were reviewed retrospectively. Demographic information, visit dates, scheduled follow-ups, and specific patients' glaucoma histories were all extracted from the records. Patients were categorized as adherent, non-adherent, or lost to tertiary follow-up (LTTF). RESULTS Of 91 patients, 52 (57.1%) were adherent, 20 (22%) were non-adherent, and 19 (20.9%) were LTTF. Most adherent patients were Saudi (59.3% adherent, 26.5% non-adherent, 14.2% LTTF) (P = 0.02). Adherent patients were far likelier to live further away from the ophthalmology clinic (P = 0.03). The frequency of clinical encounters was statistically significantly different between adherence statuses. The non-adherent group had a higher average number of prescribed ocular medications (P = 0.03). The adherent patients had more frequent visits with elevated intraocular pressure (P = 0.02). CONCLUSION A significantly high percentage of paediatric glaucoma patients were non-adherent to follow-up visits. When determining the non-compliance risk among paediatric glaucoma patients, physicians must consider the factors contributing to adherence status, which include nationality, distance to the ophthalmology clinic, and number of prescribed ocular medications.
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Affiliation(s)
- Rawan Tash
- Faculty of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Reema Alshugaig
- Faculty of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Heba Mahboob
- Faculty of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Lina H Raffa
- Ophthalmology, King Abdulaziz University Hospital, Jeddah, SAU
| | - Hanan Jamjoom
- Ophthalmology, King Abdulaziz University Hospital, Jeddah, SAU
| | | | - Ahmed Bawazeer
- Ophthalmology, King Abdulaziz University Hospital, Jeddah, SAU
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Hovanesian J, Singh IP, Bauskar A, Vantipalli S, Ozden RG, Goldstein MH. Identifying and addressing common contributors to nonadherence with ophthalmic medical therapy. Curr Opin Ophthalmol 2023; 34:S1-S13. [PMID: 36951648 DOI: 10.1097/icu.0000000000000953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
PURPOSE OF REVIEW To discuss common reasons for nonadherence and review existing and emerging options to reduce nonadherence with ocular medical therapy and optimize therapeutic outcomes. RECENT FINDINGS Nonadherence can arise from patient-related issues (e.g. physical, cognitive) and healthcare-related issues (e.g. cost, access to care). Multiple strategies have been developed and evaluated to overcome these barriers to adherence. Identifying nonadherence and its cause(s) facilitates the development of strategies to overcome it. SUMMARY Many common causes of nonadherence can be mitigated through a variety of strategies presented.
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Affiliation(s)
| | - I Paul Singh
- The Eye Centers of Racine and Kenosha, Racine, Wisconsin
| | - Aditi Bauskar
- Ocular Therapeutix, Inc., Bedford, Massachusetts USA
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7
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Medication Adherence and Common Barriers for Caregivers of Preschool Children with Pediatric Glaucoma. J Ophthalmol 2022. [DOI: 10.1155/2022/6389822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Purpose. To investigate the medication adherence among caregivers of preschool children with pediatric glaucoma and to elucidate common barriers leading to poor adherence. Methods. A cross-sectional study. Caregivers of preschool children with pediatric glaucoma completed a questionnaire on demographic information of caregivers, demographic and disease characteristics of children, caregivers-reported medication adherence (by an adapted Morisky Adherence Scale), and possible 13 barriers. Results. Overall 132 questionnaires were considered valid. Thirty-six percent of all reported poor medication adherence. Caregivers’ age and self-evaluated knowledge about pediatric glaucoma showed a significant difference between the adherent and nonadherent groups (
). Nineteen percent of all reported only one barrier as important, 65% cited multiple barriers, and 16% cited no barriers. Anxiety and depression were cited as important by most caregivers in both groups. Univariate logistic regression analysis demonstrated that difficulty with the acquisition of medications (OR, 2.5; 95% CI, 1.1–5.7;
), difficulty with medication schedule (OR, 2.3; 95% CI, 1.0–5.0;
), and high expenses for medications (OR, 4.8; 95% CI, 1.4–15.9;
) were significantly associated with higher odds of poor adherence. Conclusions. Over one-third of caregivers of preschool children with pediatric glaucoma were in poor medication adherence. Nearly two-thirds of caregivers cited multiple barriers simultaneously as important hindrances to medication usage. Anxiety and depression, difficulty with the acquisition of medications, difficulty with the medication schedule, and high expenses for medications were prominent barriers. Individualized solutions should be provided according to reported barriers by each caregiver and the other most common barriers.
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Awwad O, AlMuhaissen S, Al-Nashwan A, AbuRuz S. Translation and validation of the Arabic version of the Morisky, Green and Levine (MGL) adherence scale. PLoS One 2022; 17:e0275778. [PMID: 36206237 PMCID: PMC9543961 DOI: 10.1371/journal.pone.0275778] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 09/23/2022] [Indexed: 11/06/2022] Open
Abstract
The Morisky Green Levine (MGL) adherence scale is a 4-item tool used for the detection of medication nonadherence among patients with chronic health conditions. Despite being widely used in Arabic-speaking research contexts, it has never been validated in Arabic language. The aim of this study was to translate and validate the MGL tool into Arabic. A standard forward-backward process was used to translate the questionnaire. Cronbach’s alpha coefficient was measured to assess internal consistency of the scale. The test-retest reliability measured the consistency of participants’ responses over time. Construct validity was evaluated by Explanatory factor analysis (EFA); Kaiser-Meyer-Olkin value and Bartlett’s test of sphericity were determined. Convergent validity was assessed using a preexisting medications Arabic Adherence Assessment Tool (AAAT). The model fit was evaluated using confirmatory factor analysis (CFA). Associations between the MGL scale scores and the patient demographic/clinical characteristics were tested by linear regressions. A total of 201 participants were included into the study. The MGL scale categorization revealed that 20.9%, 59.2% and 19.9% of the participants had high, moderate and low levels of adherence respectively. Adequate internal consistency (alpha = 0.593) was observed. A significant strong ICC and Pearson’s correlations were generated between responses at time 1 and time 2. EFA results elucidated the suitability of the data for factor analysis. Pearson’s coefficient (r) revealed a significant strong correlation between MGL scale and AAAT. CFA results confirmed a good fit for the suggested model. Linear regression revealed higher number of medications, more frequent outpatient clinic visits and not experiencing medication adverse effect factors significantly associated with better adherence. The Arabic version of MLG scale is a reliable valid tool to assess adherence among Arabic-speaking communities. Implementing interventions targeting patients not compliant to regular clinic visits and those at higher risk of experiencing medication side effects can greatly enhance medication adherence.
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Affiliation(s)
- Oriana Awwad
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, University of Jordan, Amman, Jordan
- * E-mail:
| | - Suha AlMuhaissen
- Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy, University of Jordan, Amman, Jordan
| | - Ayat Al-Nashwan
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, University of Jordan, Amman, Jordan
| | - Salahdein AbuRuz
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, University of Jordan, Amman, Jordan
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
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A Randomized, Double-Masked, Active-Controlled, Crossover Phase III Equivalence Study of Generic Dorzolamide 2% versus Innovator Trusopt® Eye Drop Solution in Subjects with Open-Angle Glaucoma or Ocular Hypertension. J Ophthalmol 2022; 2022:5249922. [PMID: 35909461 PMCID: PMC9329021 DOI: 10.1155/2022/5249922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 06/13/2022] [Accepted: 06/28/2022] [Indexed: 11/23/2022] Open
Abstract
Background The aim of this study was to demonstrate the equivalence of generic dorzolamide 2% eye drops solution versus the innovator formulation (Trusopt® eye drops solution) in patients with open-angle glaucoma or ocular hypertension. Methods This prospective, monocentric, double-masked, active-controlled crossover phase III study included 32 patients. After washout, patients were randomized to reference product (Trusopt®) or test product (dorzolamide 2% eye drops, Rompharm Company SRL) for a 4-week period. Subsequent washout and crossover were performed. Drops were applied t.i.d. The primary efficacy endpoint was the difference in mean diurnal IOP. Goldmann applanation tonometry was performed at 8 am, 12 pm, and 4 pm at each visit, and safety was assessed by documentation of adverse events (AEs). Therapy adherence was documented by self-reporting and eye drop bottle weighing. An ANOVA with treatment, sequence, study period, and patient within the sequence as effects was performed and an additional post hoc ANCOVA including the baseline IOP was also performed. Results 34 patients were randomized and analyzed in the safety population. The per-protocol population included 32 patients. According to the self-report, all patients were >80% compliant. Under the ANCOVA model, the 90% confidence interval for the average change of the IOP −0.27 mmHg (−1.17 mmHg–0.64 mmHg) is included by the acceptance range −1.5 mmHg to +1.5 mmHg after excluding 2 patients, which had falsely reported high therapy adherence. No clinically relevant difference was observed in frequency or severity of the AEs between both treatments. Conclusions This study showed the equivalence of the tested generic dorzolamide 2% eye drops solution to the reference product Trusopt® eye drops solution. Trial Registration. This trial is registered with (ClinicalTrials.gov (identifier: NCT00878917) on April 9, 2009).
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10
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Adherence to Therapy in Glaucoma Treatment—A Review. J Pers Med 2022; 12:jpm12040514. [PMID: 35455630 PMCID: PMC9032050 DOI: 10.3390/jpm12040514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 12/20/2022] Open
Abstract
Glaucoma is a chronic disease and the second leading cause of irreversible vision loss worldwide, whose initial treatment consists of self-administered topical ocular hypotensive eyedrops. Adherence with glaucoma medications is a fundamental problem in the care of glaucoma patients as up to 50% of patients fail to receive the intended benefits of the treatment. The literature has identified many barriers to patients’ compliance, from factors depending on the type of medication administered, communication between physician and patients, to factors dependent on patients’ behaviour and lifestyle. Failure to take medication as prescribed increases the risk that patients will not receive the desired benefit, which often leads to a worsening of the disease. Our aim is to synthesize the methods used for measuring adherence of patients to glaucoma therapy and the interventions used for addressing adherence, laying emphasis on a patient-centred approach, taking time to educate patients about their chronic disease and to assess their views on treatment.
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Sobolewska B, Sabsabi M, Ziemssen F. Importance of Treatment Duration: Unmasking Barriers and Discovering the Reasons for Undertreatment of Anti-VEGF Agents in Neovascular Age-Related Macular Degeneration. Clin Ophthalmol 2021; 15:4317-4326. [PMID: 34737546 PMCID: PMC8558036 DOI: 10.2147/opth.s325763] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 09/13/2021] [Indexed: 12/21/2022] Open
Abstract
Purpose Since non-adherence (NA) to intravitreal therapy with VEGF drugs is one of the most important modifiable factors compromising treatment outcome of nAMD, the purpose of this study was to investigate the contributing factors and barriers during long-term nAMD treatment. Methods Barriers and potential reasons for NA were prospectively measured using the Adherence Barriers Questionnaire Intravitreal Therapy (ABQ-IVT). A random sample of patients receiving intravitreal therapy was drawn based on data for different treatment periods. Three age-sex matched groups included the treatment periods of ≤30 months (group 1), between >30 months and ≤60 months (group 2), and >60 months (group 3). The occurrence of gaps between treatments and/or OCT visits was evaluated. Results NA with gaps of >56 days after the scheduled appointment was detected in 39%, 89%, and 100% of patients in group 1, 2, and 3, respectively (groups 1 and 2 vs group 3, p < 0.001). Two or more of such gaps were observed in 6%, 72%, and 94% of patients in group 1, 2, and 3, respectively. The overall ABQ-IVT score showed corresponding differences between the groups: 25.89 ± 7.68 (group 1, 95% CI 22.07–29.71), 34.72 ± 10.32 (group 2, 95% CI: 29.59–38.86), and 33.28 ± 9.04 (group 3, 95% CI 28.78–37.77). Accordingly, the score was inversely correlated with the number of regular follow-up visits in groups 2 and 3 (Pearson correlation coefficient r = −0.65 (p = 0.003) and r = −0.5 (p = 0.034), respectively). Within the groups of longer treatment duration, univariate logistic regression analysis showed higher odds of time commitment and challenge accompanying person to be relevant barriers. Conclusion NA is an arising problem with increasing duration of intravitreal therapy. Treatment barriers, detected by the ABQ-IVT, might change or increase during the course of the treatment.
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Affiliation(s)
- Bianka Sobolewska
- Center for Ophthalmology, Eberhard- Karls University, Tuebingen, Germany
| | - Muhammed Sabsabi
- Center for Ophthalmology, Eberhard- Karls University, Tuebingen, Germany
| | - Focke Ziemssen
- University Eye Hospital, Center for Ophthalmology, University of Tübingen, Tuebingen, Germany.,Department of Ophthalmology, University Hospital Leipzig, Leipzig, Germany
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Kim JM, Sung KR, Kim HK, Park SW, Lee EJ, Jeoung JW, Park HYL, Ahn J, Yoo C, Kim CY. Long-Term Effectiveness and Safety of Tafluprost, Travoprost, and Latanoprost in Korean Patients with Primary Open-Angle Glaucoma or Normal-Tension Glaucoma: A Multicenter Retrospective Cohort Study (LOTUS Study). J Clin Med 2021; 10:jcm10122717. [PMID: 34205421 PMCID: PMC8235659 DOI: 10.3390/jcm10122717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/09/2021] [Accepted: 06/17/2021] [Indexed: 12/29/2022] Open
Abstract
This multicenter retrospective cohort study compared the effectiveness and safety of long-term tafluprost, travoprost, or latanoprost in patients with primary open-angle glaucoma (POAG) or normal-tension glaucoma (NTG). Data were extracted from electronic medical records of 300 patients treated with tafluprost, travoprost, or latanoprost for >6 months. Propensity matching for age and sex was used for effectiveness and safety comparisons. The primary endpoint was visual field (VF) progression via mean deviation (MD) slope. Secondary endpoints were change of MD, intraocular pressure, pattern standard deviation, VF index, and advanced glaucoma intervention study score. Treatment-related adverse events (AEs) were also compared between groups. Overall, 216 POAG or NTG patients were matched into Match Set 1 (72 patients/group), and 177 NTG-only patients in Match Set 2 (59 patients/group) according to: age (mean: 61, 62 years) and sex (male: 53, 56%). There were no statistically significant between-group differences regarding MD slope (p = 0.413, p = 0.374 in Match Sets 1 and 2, respectively). There were no significant between-group differences/tendencies regarding secondary endpoints. No AEs were serious, and there were no significant between-group differences regarding reported AEs. In patients with POAG or NTG, long-term tafluprost, travoprost, or latanoprost showed similar effects. All three prostaglandin analogs had good long-term safety profiles.
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Affiliation(s)
- Joon-Mo Kim
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea;
| | - Kyung-Rim Sung
- Department of Ophthalmology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul 05505, Korea;
| | - Hwang-Ki Kim
- Department of Ophthalmology, Kim’s Eye Hospital, Myung-Gok Eye Research Institute, Konyang University, Seoul 07301, Korea;
| | - Sang-Woo Park
- Department of Ophthalmology and Research Institute of Medical Sciences, Chonnam National University Medical School and Hospital, Gwangju 61469, Korea;
| | - Eun-Ji Lee
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea;
| | - Jin-Wook Jeoung
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul 03080, Korea;
| | - Hae-Young Lopilly Park
- Department of Ophthalmology, Seoul St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
| | - Jaehong Ahn
- Department of Ophthalmology, Ajou University School of Medicine, Suwon 16499, Korea;
| | - Chungkwon Yoo
- Department of Ophthalmology, Korea University College of Medicine, Seoul 02841, Korea;
| | - Chan-Yun Kim
- Institute of Vision Research, Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
- Correspondence: ; Tel.: +82-2-2228-3580; Fax: +82-2-312-0541
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Kang JM, Chatterjee A, Rosdahl JA, Bosworth HB, Woolson S, Olsen M, Sexton M, Kirshner M, Muir KW. Health Literacy and Success with Glaucoma Drop Administration. Ophthalmol Glaucoma 2021; 5:26-31. [PMID: 34052458 DOI: 10.1016/j.ogla.2021.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/19/2021] [Accepted: 05/21/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To assess the relationship between health literacy and successful glaucoma drop administration. DESIGN Substudy of a single-site interventional randomized controlled trial. PARTICIPANTS Veterans receiving care at the Durham Veterans Affairs Eye Clinic who had a diagnosis of open-angle glaucoma were recruited if they endorsed poor drop adherence. METHODS Participants underwent a health literacy evaluation using the Rapid Estimate of Adult Literacy in Medicine (REALM) as well as a qualitative assessment of eye drop administration technique using 3 different criteria: (1) the drop was instilled in the eye, (2) only 1 drop was dispensed, and (3) the bottle was not potentially contaminated. A multivariate logistic regression model was used to assess the association of REALM score and successful drop administration, adjusting for age, disease severity, and Veterans Administration Care Assessment Needs (CAN) score. MAIN OUTCOME MEASURES Successful drop administration. RESULTS Of the 179 participants with REALM scores and observed drop administration, 78% read at a high school level (HSL) or more and 22% read at less than HSL. Of the 179 participants, 87% (n = 156) successfully instilled the drop into the eye (criterion 1). A greater proportion of participants who read at HSL or more successfully instilled the drop in the eye compared with those reading at less than HSL (90.6% vs. 75.0%; P = 0.02). Rates of success with criterion 1 were similar across different levels of visual field severity. Care Assessment Needs scores were not statistically significant between those who did and those did not have successful overall drop technique. CONCLUSIONS Poor health literacy may be associated with decreased successful drop instillation in the eye in patients with glaucoma. Screening for and considering health literacy in developing interventions to improve glaucoma self-management may improve treatment adherence in a vulnerable population.
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Affiliation(s)
- J Minjy Kang
- Department of Ophthalmology, Northwestern University, Chicago, Illinois
| | - Ayan Chatterjee
- Glaucoma Service, Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Jullia A Rosdahl
- Department of Ophthalmology, Duke University, Durham, North Carolina
| | - Hayden B Bosworth
- Department of Ophthalmology, Duke University, Durham, North Carolina; Durham VA Medical Center, Durham, North Carolina
| | | | - Maren Olsen
- Department of Ophthalmology, Duke University, Durham, North Carolina; Durham VA Medical Center, Durham, North Carolina
| | - Malina Sexton
- Department of Ophthalmology, Duke University, Durham, North Carolina
| | | | - Kelly W Muir
- Department of Ophthalmology, Duke University, Durham, North Carolina; Durham VA Medical Center, Durham, North Carolina.
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14
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Khaled A, Makki S, Almaghaslah D, Al-Qahtani M, Siddique A. Patients’ adherence to topical antiglaucoma medications in a tertiary care hospital. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2021. [DOI: 10.1093/jphsr/rmab020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Objectives
Adherence to glaucoma medications is a central factor to control intraocular pressure and manage glaucoma effectively. This study aims to assess the level of adherence of glaucoma patients to ocular hypotensive agents and determine factors contributing to non-adherence in the Aseer region.
Methods
This was a single-centre, prospective cross-sectional study carried out in Aseer Hospital, Saudi Arabia. Data were collected through a customized questionnaire adapted from the Morisky, Green and Levine Medication Adherence Questionnaire (MGLS).
Key findings
Of the 102 glaucoma patients, 63 (61.8%) were non-adherent to their glaucoma medications. About 48 (76.2%) of them reported that they have no background information about glaucoma. Older participants (37, 58.7%; >50 years) showed a low adherence level compared with the younger individuals. Contributing factors to non-adherence include forgetting the dose time (32, 50.8%), illiteracy (31, 49.2%; P = 0.313), economic problems (26, 41.3%; P = 0.286) and lack of information about prescribed medications (15, 23.8%; P = 0.188).
Conclusions
No significant relationship was found between medication adherence and patient’s demographic data or their background knowledge about glaucoma. Despite the need for improving the glaucoma patient’s knowledge of their disease and the importance of medication adherence, an additional strategy as alerts by smartwatches should be encouraged to improve the adherence level.
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Affiliation(s)
- Arwa Khaled
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
- Department of Clinical Pharmacy, Beni-Suef University Hospital, Beni-Suef University, Beni-Suef, Egypt
| | - Soha Makki
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Dalia Almaghaslah
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Masoud Al-Qahtani
- Department of Ophthalmology, Aseer Central Hospital, Ministry of Health, Abha, Saudi Arabia
| | - Ayesha Siddique
- Department of Ophthalmology, Aseer Central Hospital, Ministry of Health, Abha, Saudi Arabia
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15
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Abstract
PRéCIS:: Univariate and multivariable models using the Glaucoma Treatment Compliance Assessment Tool (GTCAT) statements identified multiple, patient-specific factors associated with adherence that could be used to inform personalized interventions to optimize glaucoma adherence. PURPOSE The purpose of this study was to determine the health behavior factors related to glaucoma adherence in patients with self-reported poor adherence. METHODS A research coordinator used the Chang Adherence Measure and the Morisky Medication Adherence Scale to identify subjects with poor self-reported glaucoma medication adherence and enrolled them in a 3-month study to electronically monitor medication adherence. At enrollment, the coordinator administered the GTCAT. We calculated the percentage of prescribed doses taken over a 3-month period using an electronic dose monitor (AdhereTech). We used Rasch analysis, and univariate and multivariable regression to determine the GTCAT statements that predicted electronically monitored adherence. RESULTS The mean adherence was 73.8% (SD=21.04%, range: 13% to 100%). Rasch analysis showed that the GTCAT had a good overall fit and no differential bias (Anderson likelihood ratio test >0.05). Multiple GTCAT statements were associated with adherence, which represented increased knowledge, increased cues-to-action, decreased barriers, less depression, and increased self-efficacy (P<0.09 for each). The full GTCAT or a subset of statements had a high association with adherence (R range: 0.44 to 0.51, P<0.005 for all). The GTCAT identified >50% of patients who wanted more education about glaucoma; >68% who did not use reminders; and >40% who reported having difficulty using the eye drops. CONCLUSIONS The GTCAT identified multiple factors associated with adherence. Clinicians and researchers could use this tool to identify specific barriers to adherence and develop potential interventions to improve adherence.
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16
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New strategies for the management of ocular surface disease in glaucoma patients. Curr Opin Ophthalmol 2021; 32:134-140. [PMID: 33492867 DOI: 10.1097/icu.0000000000000739] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE OF REVIEW Glaucoma patients commonly suffer from ocular surface disease (OSD). As treatment strategies, medications and devices for the treatment of OSD as well as glaucoma surgical approaches evolve rapidly, it is important to consider their application to these patients. RECENT FINDINGS OSD in glaucoma patients may lead to reduced reliability of diagnostic tests, decreased medication compliance, poor surgical outcomes, and overall decreased quality of life. Chronic use of topical glaucoma medications has been linked to the development of limbal stem cell deficiency, and the role of preservatives in OSD continues to be demonstrated. Preservative free glaucoma medications as well as new anti-inflammatory agents for the treatment of OSD are now available. Omega-3 fatty acid supplementation and punctal plugs have been shown to benefit glaucoma patients with OSD. Drop burden may be reduced through the use of the new sustained-release delivery systems, selective laser trabeculoplasty, and minimally invasive glaucoma surgery. SUMMARY There are multiple emerging strategies for managing OSD that may be applied to patients with glaucoma. With continued research and clinical experiences, we hope to better understand the multifaceted relationship between glaucoma and OSD and develop evidence-based algorithms for the management of these complex patients.
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Smith SM, Salmon JH, Abbaraju S, Amin R, Gilger BC. Tolerability, pharmacokinetics, and pharmacodynamics of a brinzolamide episcleral sustained release implant in normotensive New Zealand white rabbits. J Drug Deliv Sci Technol 2021. [DOI: 10.1016/j.jddst.2020.102123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Sanchez FG, Mansberger SL, Kung Y, Gardiner SK, Burgoyne CF, Cunningham ET, Rees JP, Jones EP, Kinast RM. Novel Eye Drop Delivery Aid Improves Outcomes and Satisfaction. Ophthalmol Glaucoma 2021; 4:440-446. [PMID: 33444854 DOI: 10.1016/j.ogla.2021.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 12/29/2020] [Accepted: 01/05/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To compare a nose-pivoted drop delivery device (NPDD) with traditional eye drop delivery in glaucoma subjects. DESIGN Repeated-measures case series. PARTICIPANTS Fifty glaucoma subjects (100 eyes) who reported difficulty self-administering eye drops. METHODS We compared eye drop delivery using a NPDD against traditional delivery techniques at baseline (baseline traditional) and after standardized teaching (post-teaching traditional). Subjects used a 1-to-10 scale (10 being easiest) to rate the ease of delivery with each technique and completed a satisfaction survey. Two graders used digital video to independently review eye drop delivery and recorded: (1) accurate placement: the eye drop reached the ocular surface; (2) no contact: no bottle tip contact against the ocular or periocular surface; and (3)number of eye drops dispensed. We defined primary success as accurate placement and no contact; secondary success as primary success with only 1 drop dispensed. MAIN OUTCOME MEASURES We used logistic-transformed generalized estimating equation (GEE) regression to compare technique satisfaction, accuracy, no contact, and primary and secondary success. Number of drops dispensed was compared using a Cox model. RESULTS Forty-seven of 50 subjects (94%) preferred the NPDD over traditional eye drop delivery. The mean score for ease of use was higher for the NPDD (8.9 ± 1.1) than baseline traditional (6.7 ± 2.1; P < 0.001) and post-teaching traditional (7.0 ± 2.0; P < 0.001). Forty-nine of 50 (98%) subjects thought the NPDD was comfortable to use and would recommend the device. The eye drop reached the ocular surface in a similar percentage of subjects (>90%) with each method. The bottle tip contacted fewer eyes with the NPDD (10 eyes) than baseline traditional (33 eyes; P < 0.001) and post-teaching traditional (25 eyes; P = 0.009). The number of drops dispensed was lower with the NPDD (1.7 ± 1.2) than baseline traditional (2.2 ± 1.6; P = 0.017) and post-teaching traditional (2.4 ± 1.8; P = 0.006). The NPDD increased primary and secondary success of eye drop delivery (86% and 54%, respectively) compared to baseline traditional (66% [P = 0.001] and 28% [P < 0.001]) and post-teaching traditional (70% [P = 0.005] and 40% [P = 0.018]). CONCLUSIONS Eye drop users preferred the NPDD over traditional eye drop delivery. The NPDD improved eye drop delivery success, reduced bottle tip contact, and decreased the number of eye drops wasted.
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Affiliation(s)
- Facundo G Sanchez
- Legacy Devers Eye Institute, Portland, Oregon; Discoveries in Sight Research Laboratories, Devers Eye Institute, Portland, Oregon
| | - Steven L Mansberger
- Legacy Devers Eye Institute, Portland, Oregon; Discoveries in Sight Research Laboratories, Devers Eye Institute, Portland, Oregon
| | | | - Stuart K Gardiner
- Discoveries in Sight Research Laboratories, Devers Eye Institute, Portland, Oregon
| | - Claude F Burgoyne
- Discoveries in Sight Research Laboratories, Devers Eye Institute, Portland, Oregon
| | - Emmett T Cunningham
- Department of Ophthalmology, California Pacific Medical Center, San Francisco, California; Department of Ophthalmology, Stanford University School of Medicine, Stanford, California; The Francis I. Proctor Foundation, University of California, San Francisco, School of Medicine, San Francisco, California
| | - Jack P Rees
- Legacy Devers Eye Institute, Portland, Oregon
| | | | - Robert M Kinast
- Legacy Devers Eye Institute, Portland, Oregon; Discoveries in Sight Research Laboratories, Devers Eye Institute, Portland, Oregon.
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Assil KK, Greenwood MD, Gibson A, Vantipalli S, Metzinger JL, Goldstein MH. Dropless cataract surgery: modernizing perioperative medical therapy to improve outcomes and patient satisfaction. Curr Opin Ophthalmol 2021; 32 Suppl 1:S1-S12. [PMID: 33273209 DOI: 10.1097/icu.0000000000000708] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
PURPOSE OF REVIEW Advances in pharmacology offer freedom from topical medical therapy without compromise of anti-inflammatory and antimicrobial coverage in the perioperative period. In this review, we describe the basis for dropless cataract surgery with the goal of improving outcomes and the patient experience. RECENT FINDINGS Phacoemulsification outcomes depend largely on surgeon skill but also on adherence to a complex multidrug regimen of perioperative anti-inflammatory and antimicrobial therapy to prevent sight-threatening complications such as cystoid macular edema or endophthalmitis. Successful administration of this regimen can be limited by noncompliance, difficulty administering eye drops, bioavailability, and side effects, among others. The recent development of sustained-release formulations of dexamethasone - one an intracanalicular insert and the other an intraocular suspension - can provide sustained tapering doses of dexamethasone while reducing or eliminating the need for anti-inflammatory eye drop therapy. Similarly, mounting evidence compellingly demonstrates that intracameral antibiotic use intraoperatively is at least as effective as topical antibiotics in preventing endophthalmitis. SUMMARY Sustained-release dexamethasone coupled with intracameral antibiotics at the time of phacoemulsification can provide antimicrobial and anti-inflammatory prophylaxis without the need for topical eye drop medications. This approach has the potential to improve compliance with therapy, visual acuity outcomes, and the overall patient experience.
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Affiliation(s)
| | | | - Andrea Gibson
- Ocular Therapeutix, Inc., Bedford, Massachusetts, USA
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20
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Rosu AM, Coelho A, Camacho P. Assessment of medication therapy adherence in glaucoma: scoping review. EXPERT REVIEW OF OPHTHALMOLOGY 2020. [DOI: 10.1080/17469899.2020.1842197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Amalia Mihaela Rosu
- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbon, Portugal
| | - André Coelho
- ESTeSL- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbon, Portugal
| | - Pedro Camacho
- ESTeSL- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbon, Portugal
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21
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Balendra SI, Zollet P, Cisa Asinari Di Gresy E Casasca G, Cordeiro MF. Personalized approaches for the management of glaucoma. EXPERT REVIEW OF PRECISION MEDICINE AND DRUG DEVELOPMENT 2020. [DOI: 10.1080/23808993.2020.1756770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Shiama Indu Balendra
- The Western Eye Hospital, Imperial College Healthcare NHS Trust (ICHNT), London, UK
- The Imperial College Ophthalmic Research Group (ICORG), Imperial College, London, UK
- Glaucoma and Retinal Neurodegeneration Group, Department of Visual Neuroscience, UCL Institute of Ophthalmology, London, UK
| | - Piero Zollet
- The Imperial College Ophthalmic Research Group (ICORG), Imperial College, London, UK
- Department of Ophthalmology, University Vita-Salute San Raffaele, San Raffaele Scientific Institute, Milan, Italy
| | - Gloria Cisa Asinari Di Gresy E Casasca
- The Imperial College Ophthalmic Research Group (ICORG), Imperial College, London, UK
- Department of Ophthalmology, University Vita-Salute San Raffaele, San Raffaele Scientific Institute, Milan, Italy
| | - Maria Francesca Cordeiro
- The Western Eye Hospital, Imperial College Healthcare NHS Trust (ICHNT), London, UK
- The Imperial College Ophthalmic Research Group (ICORG), Imperial College, London, UK
- Glaucoma and Retinal Neurodegeneration Group, Department of Visual Neuroscience, UCL Institute of Ophthalmology, London, UK
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22
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Aguilar-Rivera M, Erudaitius DT, Wu VM, Tantiongloc JC, Kang DY, Coleman TP, Baxter SL, Weinreb RN. Smart Electronic Eyedrop Bottle for Unobtrusive Monitoring of Glaucoma Medication Adherence. SENSORS 2020; 20:s20092570. [PMID: 32366013 PMCID: PMC7248824 DOI: 10.3390/s20092570] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 04/22/2020] [Accepted: 04/25/2020] [Indexed: 11/16/2022]
Abstract
Glaucoma, the leading cause of irreversible blindness, affects >70 million people worldwide. Lowering intraocular pressure via topical administration of eye drops is the most common first-line therapy for glaucoma. This treatment paradigm has notoriously high non-adherence rates: ranging from 30% to 80%. The advent of smart phone enabled technologies creates promise for improving eyedrop adherence. However, previous eyedrop electronic monitoring solutions had awkward medication bottle adjuncts and crude software for monitoring the administration of a drop that adversely affected their ability to foster sustainable improvements in adherence. The current work begins to address this unmet need for wireless technology by creating a “smart drop” bottle. This medication bottle is instrumented with sensing electronics that enable detection of each eyedrop administered while maintaining the shape and size of the bottle. This is achieved by a thin electronic force sensor wrapped around the bottle and underneath the label, interfaced with a thin electronic circuit underneath the bottle that allows for detection and wireless transmission to a smart-phone application. We demonstrate 100% success rate of wireless communication over 75 feet with <1% false positive and false negative rates of single drop deliveries, thus providing a viable solution for eyedrop monitoring for glaucoma patients.
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Affiliation(s)
- Marcelo Aguilar-Rivera
- Department of Bioengineering, University of California San Diego, La Jolla, San Diego, CA 92093, USA; (M.A.-R.); (D.T.E.); (V.M.W.); (D.Y.K.); (T.P.C.)
| | - Dieanira T. Erudaitius
- Department of Bioengineering, University of California San Diego, La Jolla, San Diego, CA 92093, USA; (M.A.-R.); (D.T.E.); (V.M.W.); (D.Y.K.); (T.P.C.)
| | - Vincent M. Wu
- Department of Bioengineering, University of California San Diego, La Jolla, San Diego, CA 92093, USA; (M.A.-R.); (D.T.E.); (V.M.W.); (D.Y.K.); (T.P.C.)
| | - Justin C. Tantiongloc
- Department of Computer Science and Engineering, University of California San Diego, La Jolla, San Diego, CA 92093, USA;
| | - Dae Y. Kang
- Department of Bioengineering, University of California San Diego, La Jolla, San Diego, CA 92093, USA; (M.A.-R.); (D.T.E.); (V.M.W.); (D.Y.K.); (T.P.C.)
| | - Todd P. Coleman
- Department of Bioengineering, University of California San Diego, La Jolla, San Diego, CA 92093, USA; (M.A.-R.); (D.T.E.); (V.M.W.); (D.Y.K.); (T.P.C.)
- Hamilton Glaucoma Center, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, San Diego, CA 92093, USA;
| | - Sally L. Baxter
- Hamilton Glaucoma Center, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, San Diego, CA 92093, USA;
- Health Department of Biomedical Informatics, University of California San Diego, La Jolla, San Diego, CA 92093, USA
| | - Robert N. Weinreb
- Department of Bioengineering, University of California San Diego, La Jolla, San Diego, CA 92093, USA; (M.A.-R.); (D.T.E.); (V.M.W.); (D.Y.K.); (T.P.C.)
- Hamilton Glaucoma Center, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, San Diego, CA 92093, USA;
- Correspondence: ; Tel./Fax: +1-858-534-8824
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