Is an Electronic Device (Travalert Tm) Aimed at Facilitating the Use of Topical Prostaglandin Analogue Monotherapy Helpful for Glaucoma Patients?

Abstract

Purpose:: to assess whether an electronic device (Travalert^TM) incorporating a drug bottle, a small leverage to squeeze it and an acoustic reminder, may help glaucoma patients in managing a prostaglandin analog qd monotherapy.

Methods:: we selected consecutive bilateral open-angle glaucoma patients already on travoprost monotherapy coming for routine visits in our glacoma service. Subjects were given a device recording date, time and number of drop instillations. The alarm function was initially set to off. Patients were told that the device was meant to help them squeeze the bottle and put the drops in their eyes, and tried it in front of us until a correct employ was achieved. They were instructed to put the drop at 10 p.m., and were asked to bring the device back in 4 weeks. At the interim visit we downloaded the data, activated the acoustic reminder, setting it on 10 p.m., informed patients about this and asked them to use the device for further 4 weeks. At the final visit patients were administered a questionnaire to rate usefulness and liking of Travalert^TM. We also evaluated the percentage of doses administered at 10 p.m. ±30 min, and the percentage of missed doses in the two 4-week intervals.

Results:: 22 patients were enrolled and 18 of them completed the study (1 patient lost the device; 3 delayed the interim visit over 1 week), and were included in the analysis. Mean patients' age was 65±8 years. All subjects reported no problem in using the device and 16 (89%) stated that it made administration easier both by helping to squeeze the bottle and to get the drop in the eye, but 12 (66%) complained about not hearing the feeble alarm of the device. Overall, the number of doses administered at 10 p.m. ±30 min was only 27.5% and the activation of the acoustic reminder increased it to 32% (n.s.), but we observed a relevant improvement in administration timing in 39% of the patients, in whom the percentage of drops administered on time increased by up to 73%, and the percentage of missed doses fell by up to 22%.

Conclusions:: Travalert^TM is appreciated by glaucoma patients because it facilitates drop administration and 40% of the patients seem to benefit from the acoustic reminder.

Keywords: clinical (human) or epidemiologic studies: systems/equipment/techniques • clinical (human) or epidemiologic studies: health care delivery/economics/manpower