April 2011
Volume 52, Issue 14
ARVO Annual Meeting Abstract  |   April 2011
Effect of a new Audible and Visual Reminder Device on Adherence with Topical Timolol for Glaucoma
Author Affiliations & Notes
  • Manuel M. Hermann
    Center of Ophthalmology, University of Cologne, Koeln, Germany
  • Lebriz Ersoy
    Center of Ophthalmology, University of Cologne, Koeln, Germany
  • Michael Diestelhorst
    Center of Ophthalmology, University of Cologne, Koeln, Germany
  • Footnotes
    Commercial Relationships  Manuel M. Hermann, Patent (P); Lebriz Ersoy, None; Michael Diestelhorst, Patent (P)
  • Footnotes
    Support  Unrestricted grant from Imhoff Foundation and Nolting Foundation, Cologne, Germany
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 212. doi:
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      Manuel M. Hermann, Lebriz Ersoy, Michael Diestelhorst; Effect of a new Audible and Visual Reminder Device on Adherence with Topical Timolol for Glaucoma. Invest. Ophthalmol. Vis. Sci. 2011;52(14):212.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: : Non-compliance is a major factor associated with failure of topical therapy in glaucoma. Forgetfulness is a crucial barrier to adherence that might be avoided by electronic reminder systems. This pilot study aimed to assess the potential impact of a new visual and audible reminder system on adherence to topical timolol therapy for glaucoma or ocular hypertension.

Methods: : Commercially available eye drops containing 0,5 % timolol (Timo-Comod®, Ursapharm Arzneimittel GmbH, Germany) were equipped with electronic adherence monitoring and reminder devices adapted to pump based multidose containers. After written informed consent 8 patients with glaucoma or ocular hypertension applied timolol eye drops twice daily for 3 months. Patients received new medication on monthly return appointments. During the first month the devices were programmed to record adherence without emission of any reminder signal. During the second month the therapy was enforced by audible and visual signals emitted from the electronic devices in case of non-adherence at designated hours (8 am, 8 pm). During the third month the audible and visual reminder signals were switched off again. Electronic dosing information was analyzed for mean rates of adherence, mean dosing interval and number of missed doses, defined as lack of dosing events at designated hours ± 3h. The effect of the reminder signals was assed by comparisons of means for the second (with reminder signal) and third month (without reminder signal) using non parametric tests: Mann-Whitney-U test or Wilcoxon signed rank test where applicable.

Results: : The mean dose adherence rate with activated audible and visual reminder signals was 98.6 ±1.9 % and thus significantly higher than without reminder signals (mean 76.9 ±20.1 %, p=0.04). Accordingly the mean number of missed doses was significantly reduced when the signals were active (14.0 ±9 versus 1.1 ±0.96, p=0,03). Mean dosing intervals were also reduced from 16.5 ±9.2 h to 11.9 ±2 h (p=0,05) with active reminder signals. Dose adherence was thereby improved by more than 20 % in half of the patients.

Conclusions: : Audible and visual reminder signals improved significantly adherence to topical therapy for glaucoma in this pilot study. The observed reduction of missed dosings and increase of adherence by electronic reminder systems could be helpful in glaucoma therapy. Still, the long-term effect of this reminder system on adherence remains to be studied in large cohorts.

Keywords: clinical (human) or epidemiologic studies: systems/equipment/techniques • clinical (human) or epidemiologic studies: health care delivery/economics/manpower • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials 

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