Abstract
Purpose :
The Devers Drop Device (D3) is a first-generation eye cap monitor (Figure) to objectively measure eye drop adherence and eye drop-taking behavior. It includes local and cloud storage of adherence data, wireless communication, visual and auditory alerts, and a universal fit, which allows it to attach onto any FDA-approved eye drop bottle cap. We were interested in patient reported outcome measures (PROM) using the D3.
Methods :
We enrolled research subjects with a diagnosis of glaucoma or glaucoma suspect who own an Android smartphone or iPhone, and use latanoprost eye drops at bedtime. The study included two stages: Stage 1) a 25-day period (±3 days) evaluating baseline patient adherence with the D3 device; and Stage 2) a subsequent 25-day (±3 days) period to determine the effect of the D3 device with no reminder versus a daily alert from the D3 device. At enrollment and at the last visit, we administered a questionnaire and the Glaucoma Treatment Compliance Assessment Tool (GTCAT) to determine attitudes about adherence and satisfaction with the D3. We defined adherence as the proportion of eye drops administered within +/-3 hours of the expected dosing time. We used linear regression to determine the association of adherence with sociodemographic factors, and questionnaire responses.
Results :
We enrolled 53 participants with 50 completing Stage 1 (1 patient withdrew, 1 patient had a latanoprost-related adverse event, and 1 device failure). Adherence was 90.2% ± 18% (range 32-100%). Lower adherence was associated with lack of insurance coverage for prescription medications (p=.05), higher total number of eye drop bottles used per day (p=.06), higher number of eye drops per day (p=.10), and 4 GTCAT questions (p<=.14 for each). Ninety-six percent (96%) of the subjects were able to use the device; and 98% reported that the device stayed attached to the cap. However, only 49% were able to connect the device to their home wifi network. We received several recommendations for improvement including decreasing its size and improving its connectivity.
Conclusions :
We have developed a D3 prototype for research in glaucoma adherence with good patient satisfaction. Future developments should include a smaller, consumer-ready version that is easy to connect.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.