An Adherence Survey into the use of eye drops in Inflammatory Eye Disease

Abstract

Purpose : Patients with Inflammatory Eye Disease often need long-term eye drop treatment. This may require the instillation of multiple eye drops at varying frequencies throughout the day with the potential to lead to confusion and poor adherence to treatment that could significantly impact on prognosis. We wished to evaluate adherence to topical therapy in patients with Inflammatory Eye Disease in a tertiary Eye Centre, and to identify factors that may influence this.

Methods : Data were collected from consecutive patients attending uveitis and ocular surface disease clinics between 1/08/18 to 26/11/18 who were using topical therapy. A questionnaire was designed that detailed treatment regimen, self-reported estimations of adherence to treatment and the main reason for failure to adhere. Clinical diagnosis and treatment regimen were validated against clinic letters using the Winscribe™ and Medisoft™ hospital software. A clinician completed the survey with each patient.

Results : A total of 86 patients were included: 51 uveitis patients and 35 ocular surface disease patients. Of these, 29% (25/86) of patients failed to identify 1 or more of the eye drops they were using, with 28% (24/86) unable to offer the correct indication for their treatment. Fifty five (64%) patients reported failing to put their eye drops in, with 15 (27%) of these estimating this to be on a daily basis. The mean 4-week failure rate was 7%, with the most common reason offered being forgetfulness (30%). Of the 58 patients using multiple eye drops, 22% (13/58) reported insufficient time intervals between successive eye drops, with 58% (50/86) of all participants recalling no instruction on how to instil eye drops.

Conclusions : Despite counselling in clinic by medical staff and patients receiving letters after their clinic appointment detailing their treatment, self-reported eye drop adherence in patients with Inflammatory Eye Disease is 71%. We highlight poor rates of correct intervals between eye drops and concordance with treatment that can impact upon clinical outcomes. We recommend dedicated practitioner in the clinical environment, such as an ophthalmic pharmacist, providing a more proactive approach to patient education of topical therapy (indication and treatment) to improve adherence.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.