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T. Tsai, J. Smith, A. Robin; How Do I Use My Drops? An Examination of the Settings, Circumstances, and Methods Adopted by Patients Taking Topical Glaucoma Therapy . Invest. Ophthalmol. Vis. Sci. 2003;44(13):95.
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Purpose: Multiple factors influence patients' compliance--one is the methodology of eyedrop administration. Eye care providers often overlook the importance of instruction regarding handling, storing, and administering eyedrops. These aspects of eyedrop administration may be strongly related to the success of prescribed therapies. Few attempts have been made to describe the practical aspects of patients' eyedrop administration and to identify potential problems that may adversely affect effective therapy. Methods: A two-page questionnaire was distributed to 253 patients at the time of their regular clinical visit with one of two glaucoma specialists. In addition to demographic data, patients were asked ten multiple-choice and open-ended questions about their use of eyedrops. Results: The 253 patients had a mean age of 71.45 years (SD 15.12), and were predominantly female (59.8%) and white (72.6%). 82.6% of patients administered their own eyedrops. Patients who were dependent on others for administration most commonly cited inadequate vision and trouble with manual dexterity. Most patients took drops while either sitting or standing (73.4%), and almost all those who lie down (31.6%) use the bed. Of those who self-administered drops, 16.3% used a mirror. The most common location for administration was the bedroom (46.8%), followed by the bathroom (23.4%) and kitchen (16.1%). 65.1% reported "always" or "usually" washing their hands before administering drops, compared with 15.8% who reported "rarely" or "never". 74.6% reported the dropper tip touched the eye "rarely" or "never" in contrast to 4.8% who reported "always" or "usually". Most patients used their fingers to hold the lids open while administering the drops (79.7%), and, of these, 64.2% held down the lower lid only. In reponse to "What do you not like about administering your glaucoma medications?," many described no problems, but common responses also included frustration with difficult-to-handle bottles (14.1%) and problems getting the proper dosage in the eye (12.9%). The most common storage locations included the bedroom (45.4%), bathroom (23.9%), and kitchen (19.0%). 12.2% stored the medication in the refrigerator, and over half of those did so at the instruction of a provider or the package. Conclusions: While most patients seem to have little difficulty with the use, storage, and handling of eyedrops, this study demonstrates that broad variations in reported practices exist. This suggests a need for better instruction in the use of topical eye medications to reduce patient frustration, improve compliance, and increase efficacy.
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