Success of patient training in improving proficiency of eyedrop administration among various ophthalmic patient populations

Abstract

Purpose: The purpose of this study is to evaluate the success and usefulness of patient education in eyedrop self-administration technique via an educational handout and a short instructional video.

Patients and methods: We conducted a prospective study that included 34 patients who were self-administering ophthalmic drops. Of the total patients included, 12% had used drops for <12 months, and 88% had used drops for >12 months. Average age of patients in the study was 67 years, with an age range of 19-91 years. Of the total patients included, 82% had glaucoma, 6% had dry eyes, and 12% did not have a specific diagnosis. Subjects were video recorded and assessed by a trained observer on two occasions: at baseline and after they viewed a demonstrational video and handout. A maximum score of 15 points was awarded based on 15 criteria. A written self-assessment was administered at the end of each study.

Results: Pre- and post-teaching assessment scores improved significantly with education. Patients initially scored an average 2.53 points compared to a post-education score of 6.15 out of 15 points, demonstrating a 2.43 (P=0.008) factor of improvement. After education, 94% of patients versus 47% pre-teaching (P=0.0001) pulled down their lower eyelids. A total of 91% pre-teaching versus 59% post-teaching (P=0.0042) patients squeezed one drop into the lower fornix, 74% pre-teaching versus 26% post-teaching (P=0.0002) patients released the eyelid and closed the eye for 1 minute, and 56% pre-teaching versus 3% post-teaching (P=0.0001) patients applied nasal digital pressure on each eye. We found no significant difference in score changes between those who previously received education and those who had not (P=0.37). A total of 91% patients responded in a postassessment survey that they now feel more confident of their ability to self-administer eyedrops as their doctor prescribed and that the educational materials were responsible.

Conclusion: Participants demonstrated an immediate and statistically significant improvement in several areas of proper eyedrop self-administration after exposure to a demonstration video and instructional handout.

Keywords: compliance; eye care; patient education; patient satisfaction; safety.

Figure 1

Total performance scores of eyedrop self-administration pre- and postexposure to educational tools. Notes: N=34 for both groups; mean =2.53 for group prior to education, 6.15 for group after education; standard deviation =6.22 for group prior to education, 4.82 for group after education; standard error of the mean =1.07 for group prior to education, 0.83 for group after education. Graph demonstrates that, prior to implementation of educational materials, patients scored significantly lower than after they had been taught how to properly administer eyedrops. P=0.008.

Figure 2

Performance score changes of eyedrop self-administration pre- and postexposure to educational tools broken down by previous educational experience. Notes: N=17 for both groups. For group with participants who had received previous formal education on proper eyedrop self-administration, mean =3.94, standard deviation =5.31, and standard error of the mean =1.29. For group with participants who had not received previous formal education, mean =3.29, standard deviation =5.60, and standard error =1.36. Graph demonstrates that post-education score improvement was not significantly different based on history of previous formal training of proper eyedrop administration. P=0.37.