Electronic Monitoring Improves Adherence to Drop Regimen
By Jean Shaw
Selected by Henry D. Jampel, MD, MHS
Journal Highlights
Ophthalmology Glaucoma, July/August 2022
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McGlumphy et al. set out to electronically monitor the prescribed use of topical corticosteroid drops in patients who underwent glaucoma surgery and to compare measures of adherence to postsurgical outcomes. They found that they were able to remotely monitor patient adherence, which was high overall. In addition, they found that surgical success was greater among eyes with nearly ideal adherence rates and poorer in older patients and in those with more advanced glaucoma.
For this prospective cohort study, the researchers included 90 patients (90 eyes) with open-angle glaucoma (n = 86) or angle-closure glaucoma (n = 4). Patients had undergone trabeculectomy (n = 58), combined trabeculectomy and cataract surgery (n = 20), or tube shunt surgery (n = 12). All were provided with a Kali Drop device, which is a wireless, 3G-enabled plastic unit that encloses the eyedrop bottle and records the time and amount of drop administration. Adherence parameters were designed to capture both the number of drops a patient administered each day during waking hours and the time between each drop. Main outcome measures included adherence to the drop regimen during the first five post-op weeks as well as the achievement of target IOP at six weeks, six months, and one year.
Results indicated that adherence was 89.7% ± 13.7% overall and 80.9% ± 15.8% when the drop regimen required dosing every two hours. Seventeen patients had no follow-up examinations at six months or one year; for the remaining 73, target IOP was achieved at the final visit in 59 (80.8%). Factors associated with poorer adherence included older age and features suggestive of worse glaucoma disease, such as greater visual field loss in the operated eye.
The original article can be found here.