Nose-Pivoted Dropper Aids Glaucoma Drug Delivery

A novel eye drop delivery aid improved overall outcomes and satisfaction in glaucoma patients, according to a study published in Ophthalmology Glaucoma.

The repeated-measures case series looked at the results of a nose-pivoted drop delivery device compared with traditional eye drop delivery in 100 eyes of 50 people with glaucoma who reported trouble giving themselves glaucoma eye drop medication.

Investigators compared the methods of delivery at baseline and after standardized teaching with subjects rating ease of delivery on a 1 to 10 scale (10 being the easiest), and completing a satisfaction survey. In addition, 2 graders independently reviewed eye drop delivery using digital video for accurate placement (the eye drop being accurately placed on the ocular surface); no contact (the bottle tip didn’t touch the ocular or periocular surface); and the number of drops used. 

Primary success was defined as: accurate placement and no contact; secondary success as primary success with only 1 drop dispensed. Logistic-transformed GEE regression was used to compare technique satisfaction, accuracy, no contact, and primary and secondary success, while the number of drops used was compared using a Cox model.

Investigators found that 47 out of the 50 people in the study (94%) preferred the nose-pivoted drop delivery device to the traditional method, and 49 out of 50 (98%) reported that the device was comfortable to use and that they’d recommend it. Other statistics: Mean score for ease-of-use was higher for the nose-pivoted drop delivery device (8.9 ± 1.1) than the baseline traditional method (6.7 ± 2.1, P <.001) and post-teaching traditional (7.0 ± 2.0, P <.001). When measuring eye drop being accurately placed on the ocular surface, both techniques had a similar percentage (>90%). For the bottle-tips-touching-eyes however, fewer bottle tips contacted the ocular surface with the nose-pivoted drop delivery device (10 eyes) than baseline traditional (33 eyes, P <.001) and post-teaching traditional (25 eyes, P =.009). The number of drops used was lower with the nose-pivoted drop delivery device (1.7 ± 1.2) than baseline traditional (2.2 ± 1.6, P =.017) and post-teaching traditional (2.4 ± 1.8, P =.006) too.

The nose-pivoted drop delivery device increased primary and secondary success of delivery (86% and 54%, respectively) compared with baseline traditional (66% [P =.001] and 28% [P <.001]) and post-teaching traditional (70% [P =.005] and 40% [P =.018]), according to the study.

“Eye drop users preferred the [nose-pivoted drop delivery device] over traditional eye drop delivery. The [nose-pivoted drop delivery device] improved eye drop delivery success, reduced bottle tip contact, and decreased the number of eye drops wasted,” the study explains.

The study’s limitations include that the patients involved were only given a few minutes to learn and practice both methods (longer training might have improved outcomes, researchers speculate). The study also had no follow-up, and artificial tears used in the study in place of glaucoma drops may affect the results. Patients could have also been biased for the device because it was developed by a physician at the site where they tested it. Finally, a Hawthorne effect may have occured because patients were aware they were being observed and recorded.

Disclosure: Study authors declared affiliations with the biotech or pharmaceutical industries. Please see the original reference for a full list of authors’ disclosures.

Reference

Sanchez FG, Mansberger SL, Kung Y, et al. Novel Eye Drop Delivery Aid Improves Outcomes and Satisfaction. Ophthalmol Glaucoma. Published online January 12, 2021. doi:10.1016/j.ogla.2021.01.001