Reducing omission of eye drops during hospital admission

2022 ◽  
pp. 1-7
Author(s):  
Charlotte S Ho ◽  
Darren SJ Ting ◽  
Devina Gogi
Keyword(s):  
Hospital Admission ◽  
Dry Eye ◽  
Substantial Reduction ◽  
Dry Eye Disease ◽  
National Standards ◽  
Eye Disease ◽  
Eye Drops ◽  
National Guidelines ◽  
Before And After

Background/aims Chronic ophthalmic conditions, such as glaucoma and dry eye disease, are frequently encountered debilitating eye conditions that can lead to substantial reduction in vision and quality of life. However, there is ongoing evidence to suggest that topical ophthalmic therapy is inappropriately omitted on admission to hospital. The primary aim of this audit was to investigate the trust adherence to the National Institute for Health and Care Excellence guideline on the prescribing standard of eye drops during hospital admission. The secondary aim was to raise awareness and ensure successful compliance with national standards to reduce unintentional omission of eye drops on admission and subsequent complications. Method Electronic medical records of all medical and surgical adult inpatients were studied prospectively on two different occasions. The quality of documentation of eye drops in clerking notes, the length of time taken between the admission and prescription of eye drops, and the accuracy of the prescription were examined. Following the initial audit, interventions focusing on clinician education were implemented. This includes highlighting the importance of eye drops in all departmental mandatory introductory sessions and putting up posters on all the wards as prompts. The same data collection method was used in the reaudit. Results In the initial audit, 64 (mean age 81.8±8.9 years) patients with regular prescriptions for eye drops were identified; 38 (59.4%) patients had eye drops for dry eye disease only, 20 (31.3%) patients had eye drops for glaucoma only, and six (9.4%) patients had eye drops for both. In the reaudit, 57 (mean age 76.7±15.3 years) patients were identified; 42 (73.7%) patients had eye drops for dry eye disease only, 10 (17.5%) patients had eye drops for glaucoma only, and five (8.8%) patients had eye drops for both. Following the intervention, there was a significant improvement in documentation of ocular diagnosis and eye drops on clerking notes from 41% to 65% (P=0.008), and eye drop reconciliation within 24 hours of admission improved from 45% to 75% (P=0.0008). All patients (100%) received the correct eye drop prescription before and after the intervention. Conclusions Education is effective in promoting adherence to national guidelines and reducing the incidence of inappropriate omission of eye drops on admission to hospital.

scholarly journals Cationic Thiolated Poly(aspartamide) Polymer as a Potential Excipient for Artificial Tear Formulations

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Mária Budai-Szűcs ◽  
Gabriella Horvát ◽  
Barnabás Áron Szilágyi ◽  
Benjámin Gyarmati ◽  
András Szilágyi ◽  
...  
Keyword(s):  
Dry Eye ◽  
Tear Film ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Eye Drops ◽  
Thiol Groups ◽  
Physiological Properties ◽  
Disulphide Bond Formation ◽  
Polymer Bearing

Dry eye disease is a relatively common ocular problem, which causes eye discomfort and visual disorders leading to a decrease in the quality of life. The aim of this study was to find a possible excipient for eye drop formulations, which is able to stabilize the tear film. A cationic thiolated polyaspartamide polymer, poly[(N-mercaptoethylaspartamide)-co-(N-(N′,N′-dimethylaminoethyl)aspartamide)] (ThioPASP-DME), was used as a potential vehicle. Besides satisfying the basic requirements, the chemical structure of ThioPASP-DME is similar to those of ocular mucins as it is a protein-like polymer bearing a considerable number of thiol groups. The solution of the polymer is therefore able to mimic the physiological properties of the mucins and it can interact with the mucus layer via disulphide bond formation. The resultant mucoadhesion provides a prolonged residence time and ensures protective effect for the corneal/conjunctival epithelium. ThioPASP-DME also has an antioxidant effect due to the presence of the thiol groups. The applicability of ThioPASP-DME as a potential excipient in eye drops was determined by means of ocular compatibility tests and through examinations of the interactions with the mucosal surface. The results indicate that ThioPASP-DME can serve as a potential eye drop excipient for the therapy of dry eye disease.

scholarly journals Apoptosis of conjunctival epithelial cells before and after the application of autologous serum eye drops in severe dry eye disease

2016 ◽  
Vol 160 (2) ◽  
pp. 271-275 ◽  
Author(s):  
Ivana Rybickova ◽  
Viera Vesela ◽  
Ivan Fales ◽  
Pavlina Skalicka ◽  
Katerina Jirsova
Keyword(s):  
Epithelial Cells ◽  
Dry Eye ◽  
Dry Eye Disease ◽  
Autologous Serum ◽  
Eye Disease ◽  
Eye Drops ◽  
Before And After ◽  
Serum Eye Drops ◽  
Conjunctival Epithelial Cells

scholarly journals The role of KPI-121 0.25% in the treatment of dry eye disease: penetrating the mucus barrier to treat periodic flares

2021 ◽  
Vol 13 ◽  
pp. 251584142110127
Author(s):  
Preeya K. Gupta ◽  
Nandini Venkateswaran
Keyword(s):  
Drug Delivery ◽  
Dry Eye ◽  
Ocular Surface ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Eye Drops ◽  
Short Term ◽  
Short Term Treatment ◽  
Loteprednol Etabonate ◽  
Mucus Barrier

The tear film, which includes mucins that adhere to foreign particles, rapidly clears allergens and pathogens from the ocular surface, protecting the underlying tissues. However, the tear film’s ability to efficiently remove foreign particles during blinking can also pose challenges for topical drug delivery, as traditional eye drops (solutions and suspensions) are cleared from the ocular surface before the drug can penetrate into the conjunctival and corneal epithelium. In the past 15 years, there has been an increase in the development of nanoparticles with specialized coatings that have reduced affinity to mucins and are small enough in size to pass through the mucus barrier. These mucus-penetrating particles (MPPs) have been shown to efficiently penetrate the mucus barrier and reach the ocular surface tissues. Dry eye disease (DED) is a common inflammatory ocular surface disorder that often presents with periodic flares (exacerbations). However, currently approved immunomodulatory treatments for DED are intended for long-term use. Thus, there is a need for effective short-term treatments that can address intermittent flares of DED. Loteprednol etabonate, an ocular corticosteroid, was engineered to break down rapidly after administration to the ocular surface tissues and thereby reduce risks associated with other topical steroids. KPI-121 is an ophthalmic suspension that uses the MPP technology to deliver loteprednol etabonate more efficiently to the ocular tissues, achieving in animal models a 3.6-fold greater penetration of loteprednol etabonate to the cornea than traditional loteprednol etabonate ophthalmic suspensions. In clinical trials, short-term treatment with KPI-121 0.25% significantly reduced signs and symptoms of DED compared with its vehicle (placebo). Recently approved KPI-121 0.25%, with its novel drug delivery design and ease of use, has the potential to effectively treat periodic flares of DED experienced by many patients.

scholarly journals Dry eye disease among Glaucoma patients on topical hypotensive medications, in a tertiary hospital, Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Miraf Sahlu ◽  
Abeba T. Giorgis
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Signs And Symptoms ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Eye Drops ◽  
Schirmer Test ◽  
Ocular Surface Disease Index ◽  
Cross Sectional ◽  
Corneal Staining

Abstract Background Dry eye disease is a multifactorial disease; causing various ocular symptoms with potential damage to the ocular surface. Applying hypotensive eye drops are presumed to initiate or exacerbate existing dry eye disease. The purpose of this study was to determine the frequency of signs and symptoms and severity of dry eye disease among glaucoma patients on topical hypotensive medications and controls. Methods A cross-sectional comparative study, involving 320 glaucoma patients and controls. Ocular Surface Disease Index (OSDI) symptoms score and Schirmer, tear breakup time and corneal staining tests were used to assess dry eye disease. Data was analyzed using SPSS version 24 software; p-value less than 0.05 was considered as statistically significant. Results Among the 160 study glaucoma patients, the mean duration of topical hypotensive medication use was 5.2 ± 5.21 years (range, 4 months - 32 years). Mild to severe level of OSDI score was found in 122 (76%) glaucoma patients and in 137 (86%) controls (p = 0.033). Mild to sever abnormal clinical tests in the glaucoma patients and control, respectively, were 106 (66%) vs 80 (50%) corneal staining (p = 0.045), 79 (49%) vs 72 (45%) TBUT (p = 0.021), and 91 (57%) vs 83 (52%) Schirmer test (p = 0.242). Test results at the level of sever: 2 (1%) vs 0 (0%) corneal staining, 50 (31%) vs 39 (24%) TBUT and 65 (41%) vs 60 (38%) Schirmer test in the glaucoma patents and controls, respectively. Corneal staining and TBUT had correlation with the number of drugs (p = 0.004 and 0.031, respectively), and more relationship of the two tests with total number of drops applied per day (p = 0.01 and p <  0.001, respectively). Patients on pilocarpine and timolol had more corneal staining and lower TBUT [(p = 0.011 and p <  0.001) and (p = 0.04 and 0.012), respectively]. Conclusions The study has identified glaucoma patients to be more affected by dry eye disease than non-glaucoma patients, and presence of significantly lower TBUT and higher corneal staining in the glaucoma patients on multidrops and multidose per day. We recommend consideration of evaluation and management of DED for glaucoma patients on multidrops and multidose hypotensive medications.

scholarly journals Comparison of treatment efficacy between 100% platelet-rich plasma and 100% serum eye drops in moderate-to-severe dry eye disease: a randomised controlled trial protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e048479
Author(s):  
Passara Jongkhajornpong ◽  
Pawin Numthavaj ◽  
Thunyarat Anothaisintawee ◽  
Kaevalin Lekhanont ◽  
Gareth McKay ◽  
...  
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Platelet Rich Plasma ◽  
Controlled Trial ◽  
Dry Eye Disease ◽  
Autologous Serum ◽  
Eye Disease ◽  
Eye Drops ◽  
Department Of Ophthalmology ◽  
Autologous Platelet

IntroductionDry eye disease (DED) is a common eye problem. Although the disease is not fatal, it substantially reduces quality of life and creates a high economic burden, especially in patients with moderate-to-severe DED. Several biological tear substitutes (eg, autologous serum (AS), autologous platelet-rich plasma (APRP) and autologous platelet lysate) could effectively improve dry eyes. However, evidence on their comparative efficacy is controversial. This study aims to compare the efficacy of 100% APRP with 100% AS eye drops in patients with moderate-to-severe DED.Methods and analysisThe study is a single-centre, double-blinded randomised, parallel, non-inferiority trial. One hundred and thirty patients with moderate-to-severe DED, aged 18–70 years will be recruited from outpatient clinic, Department of Ophthalmology, Ramathibodi Hospital, Bangkok from February 2021 to January 2023. Patients will be randomised to receive either 100% APRP or 100% AS eye drops (1:1 ratio) for 4 weeks. The primary outcomes are ocular surface disease index (OSDI) and ocular surface staining (OSS) evaluated using the Oxford scale. Secondary outcomes are fluorescein break-up time, Schirmer’s I test, meibomian gland parameters and adverse events. Other measured outcomes include best-corrected visual acuity, intraocular pressure and compliance.Ethics and disseminationThe study protocol and any supplements used in conducting this trial have been approved by the Ethics Committee of Faculty of Medicine, Ramathibodi Hospital, Mahidol University (MURA2020/1930). Informed consent will be obtained from all patients before study entry. Results will be presented in peer-reviewed journals and international conferences.Trial registration numberNCT04683796.

scholarly journals Frequency of efficacy of topical cyclosporine 0.05% eye drops in the management of dry eyes

2021 ◽  
Vol 15 (6) ◽  
pp. 1384-1386
Author(s):  
M. Khalid ◽  
M. Rizwan ◽  
S. Khurshid
Keyword(s):  
Dry Eye ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Eye Drops ◽  
Care Hospital ◽  
Improvement Rate ◽  
Female Patients ◽  
Department Of Ophthalmology ◽  
Male Patients ◽  
Efficacy Of Treatment

Aim: To determine the efficacy of cyclosporine 0.05% for the management of patients of dry-eye disease presenting at tertiary care hospital. Methods: This cross sectional study was conducted at Department of Ophthalmology, Sahiwal Medical College, Sahiwal from March 2020 to September 2020 over the period of 6 months.Total 310 patients of dry eye were included in this study after scrutinized by inclusion criteria. All the selected patients were managed with cyclosporine 0.05% and efficacy of the drug was assessed. Results: Total 310 patients of dry eye disease were recruited. Mean age was 47.15 ± 3.61 years and mean duration of dry eye disease was 11.10 ± 1.75 months. Out of 310 patients, treatment was found effective in 225 (73%) patients. Efficacy of treatment was noted in 172(96.63%) male patients and in 53(40.15%) female patients. Significantly higher rate of efficacy was noted in male patients as compared to female patients with p value 0.000. Conclusion: Results of present study showed higher improvement rate of dry eye symptoms in cases of dry eye managed with cyclosporine 0.05%. Male patients were more victim of dry eye as compared to female patients and statistically significant association of efficacy with gender was observed. No association of efficacy of treatment with age group and duration of disease was observed. Keywords: Dry eye, cyclosporine, inflammation, immunomodulator agents.

scholarly journals Management of moderate-to-severe dry eye disease using chitosan-N-acetylcysteine (Lacrimera®) eye drops: a retrospective case series

2020 ◽  
Vol 40 (6) ◽  
pp. 1547-1552 ◽  
Author(s):  
Johannes Nepp ◽  
Wolfgang Knoetzl ◽  
Anna Prinz ◽  
Sonja Hoeller ◽  
Martin Prinz
Keyword(s):  
Dry Eye ◽  
Case Series ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Eye Drops ◽  
Retrospective Case ◽  
Retrospective Case Series

scholarly journals Achyranthis radix Extract-Loaded Eye Drop Formulation Development and Novel Evaluation Method for Dry Eye Treatment

Pharmaceutics ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 165
Author(s):  
Sung-Jin Kim ◽  
Bongkyun Park ◽  
Hyun Wook Huh ◽  
Young-Guk Na ◽  
Minki Kim ◽  
...  
Keyword(s):  
Dry Eye ◽  
Evaluation Method ◽  
Dry Eye Disease ◽  
Herbal Extract ◽  
Good Effect ◽  
Eye Disease ◽  
Eye Drops ◽  
Dependent Manner ◽  
Formulation Development ◽  
Concentration Dependent Manner

Recently, Achyranthis radix extract has been studied as a therapeutic agent for dry eye disease that occurs from fine dust. The aim of this study was the development of Achyranthis radix extract-loaded eye drop formulations using lubricants, generally used for artificial tear eye drops. Ecdysterone was used as a marker compound for Achyranthis radix extract and 1% Achyranthis radix extract solution contained 14.37 ± 0.04 μg/mL of ecdysterone. Before formulation studies, a new method was performed to evaluate pigmentation, which might be caused by eye drops of herbal extract. A comparative study of the water retention ability of each formulation and ability to prevent the death of conjunctival epithelial cells in dry conditions was conducted. Moreover, treatment of Achyranthis radix extract (USL) eye drop formulation exhibited a significant inhibitory effect on inflammation in a concentration-dependent manner. The long-term and accelerated stability tests showed that lubricants could contribute to the stability of herbal extracts in solution. In conclusion, hyaluronic acid showed a good effect on the development of eye drop formulation using Achyranthis radix extracts for treating dry eye disease.

scholarly journals An Association Rule Analysis of Combined Acupoints for the Treatment of Patients with Dry Eye Disease

2020 ◽  
pp. 1-8
Author(s):  
Ya-Hsuan Lin ◽  
Hsein-Chang Wu ◽  
Po-Chun Hsieh ◽  
I-Shiang Tzeng ◽  
Shu-Ya Wu ◽  
...  
Keyword(s):  
Dry Eye ◽  
Association Rule ◽  
Binary Data ◽  
Meta Analysis ◽  
Poor Quality ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Film Instability ◽  
Breakup Time

<b><i>Background:</i></b> Dry eye disease (DED) has a higher incidence in old age and is seen predominantly in females worldwide. Neurosensory abnormalities, ocular surface inflammation and damage, film instability, and hyperosmolarity are major and proven pathologies responsible for a poor quality of life. Tear breakup time and Schirmer’s I test are predominantly used for the evaluation of primary outcomes in patients undergoing conventional treatment. A previous meta-analysis of some relevant studies proved that combination of acupoints could be more effective than single acupoint treatment. <b><i>Objectives:</i></b> The present study aimed to undertake association rule mining and examined the potential kernel acupoint combination in DED treatment constructed from the extracted randomized controlled trials (RCTs) based on a previous meta-analysis. <b><i>Methods:</i></b> We summarized 32 acupoints as binary data from the 12 eligible RCTs and analyzed them based on the Apriori algorithm. <b><i>Results:</i></b> TE23, BL2, ST2, ST1, EX-HN5, BL1, LI4, ST36, SP6, and KI3 were the 10 most frequently selected acupoints. The major associated rules in combination of acupoints were {TE23, LI4} ≥ {ST1} and {TE23, ST1} ≥ {LI4}, as inferred from 23 association rules. <b><i>Conclusions:</i></b> For acupuncture treatment of DED, combined TE23, LI4, and ST1 acupoints could be settled as the kernel of acupoint combination.

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