Factors Associated with Topical Medication Instillation Failure in Glaucoma: VRAMS-QPiG Study

Area of Science:

• Ophthalmology
• Geriatrics
• Clinical Pharmacy

Background:

• Glaucoma management relies heavily on effective eyedrop instillation.
• Patient self-assessment of eyedrop technique accuracy is often unreliable.

Purpose of the Study:

• To evaluate eyedrop instillation techniques in glaucoma patients.
• To identify factors contributing to eyedrop instillation failure.
• To compare patient self-assessment with objective video assessment.

Main Methods:

• A cross-sectional observational study involving 60 glaucoma patients.
• Video recording of typical eyedrop instillation technique.
• Assessment of cognitive function using the Mini-Cog test.
• Comparison of patient-reported success/failure with examiner-based video assessment.

Main Results:

• A significant discrepancy exists between self-reported and video-assessed eyedrop instillation success rates (57% inconsistency).
• Over half (54%) of observed instillations failed based on video assessment.
• Factors associated with failure included older age, lower cognitive function, less myopic refractive error, and reduced visual field sensitivity.

Conclusions:

• Older age, decreased cognitive function, hyperopia, and reduced foveal sensitivity are significant risk factors for failed eyedrop instillation in glaucoma patients.
• Physicians should proactively screen for these risk factors to identify patients needing assistance with medication instillation.
• Objective assessment methods are crucial for accurate evaluation of eyedrop instillation success.