The effect of "eye drop guide" on the success rate of eye drops self-instillation

Abstract

Non-compliance can mislead the clinicians to draw conclusion on ineffective therapy and advice more aggressive treatment. Non-compliance including improper techniques of eye drop instillation frequently occurs in chronic glaucoma patients. The Eye Drop Guide (EDG) device has been developed to ensure a precise instillation. However whether the EDG is more effective than the Traditional Technique when both techniques are carefully instructed is still unknown. We conducted the cross over study to compare success rates of eye drops self-instillation between the two techniques in chronic glaucoma patients. 59 patients were instructed to instill eye drops with the “EDG” or “Traditional technique” in a randomized sequence. Two weeks practice period was assigned before groups were crossed-over. The instillation performance was video recorded after each practice period. The self-instillation performance, total numbers of drops dispensed, time to instill eye drops of both techniques in the VDO records were scored by 3 independent readers. The results showed that, between the EDG and Traditional technique, there were no significant difference in success rates (61.0% and 66.1% respectively, P 0.607) and the numbers of drops dispensed per application (P 0.89). The time used to instill eye drops with the EDG was significantly longer than the Traditional technique (P < 0.001). Older age (≥ 70 years) and higher education (≥ high school) were found to be significantly associated with failure of the EDG. In conclusion EDG is not more effective than carefully instructed Traditional technique in terms of improving dispensing accuracy and decreasing the drops dispensed per application. Moreover it needs more time to instill eye drop into the eye.