The Association of an Upper Extremity Functional Survey and Glaucoma Medication Administration Success.
The Association of an Upper Extremity Functional Survey and Glaucoma Medication Administration Success.
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上肢功能调查与青光眼药物管理成功协会。
DOI：
10.1080/02713683.2019.1625405
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发表时间：
2019
影响因子：
2
通讯作者：
Muir,KellyW
中科院分区：
文献类型：
--
作者：
Hein,AaronM;Rosdahl,JulliaA;Bosworth,HaydenB;Woolson,SandraL;Olsen,MarenK;Kirshner,MiriamA;Muir,KellyW
目的/目的：确定上肢功能调查是否可以确定哪些患者将有滴眼液给药困难。材料和方法：在退伍军人事务眼科诊所接受治疗的青光眼患者没有自我报告100%的药物依从性，被纳入一项横断面研究。参与者根据他们观察到的将一滴滴入眼睛的能力（准确性）和从瓶子中表达不超过一滴的能力（效率）来评分。这两个条件的成功执行被定义为良好的跌落技术。参与者还完成了QuickDASH，这是一项有效的上肢功能调查，得分越高表明残疾越严重。我们假设，QuickDASH得分较低的参与者在使用滴药管理措施时观察到成功的可能性会增加。上肢合并症的诊断从参与者的医疗记录中提取出来，并归类为神经或肌肉骨骼病因的诊断组。结果：94名参与者中，80名参与者表现出成功的准确性，58名参与者表现出成功的效率，50名参与者表现出良好的掉落技术。滴眼液效果的准确性与QuickDASH评分无关（比值比（OR） [QuickDASH评分每降低10分成功给药的概率]:1.14,95% CI: 0.89-1.45,p= 0.29）。滴药管理效率的成功与QuickDASH评分密切相关（OR: 1.27, 95% CI: 1.04-1.54,p= 0.02），良好的滴药技术也是如此（OR: 1.28, 95% CI: 1.05-1.56,p= 0.01），更低（更好）的QuickDASH评分与更好的滴药技术相关。上肢神经或肌肉骨骼合并症与观察到的良好滴入技术之间没有关联。在参与者的医疗记录中，神经系统或肌肉骨骼上肢合并症的存在与较高的QuickDASH评分相关。结论：QuickDASH调查可以识别出滴眼液给药困难的患者，从而使这些人群接受有针对性的滴眼液技术教育和管理策略。缩写词：CPRS：计算机病历系统；MSK:肌肉骨骼;UE：上肢；退伍军人事务部
Purpose/Aim: To determine if an upper extremity functional survey may identify which patients will have eye drop administration difficulty.Materials and Methods: Participants with glaucoma treated at a Veterans Affairs Eye Clinic who did not self-report 100% medication adherence were enrolled in a cross-sectional study. Participants were scored on their observed ability to place a drop into the eye (accuracy) and express no more than one drop from the bottle (efficiency). Successful execution of both of these conditions was defined as good drop technique. Participants also completed the QuickDASH, a validated upper extremity functional survey, with higher scores indicating worse disability. We hypothesized participants with lower QuickDASH scores would have an increased probability of observed success with drop administration measures. Diagnoses of upper extremity co-morbidities were abstracted from participants’ medical records and clustered into diagnostic groups of either neurologic or musculoskeletal etiologies.Results: When observed, 80 of 94 participants displayed successful accuracy, 58 of 94 participants displayed successful efficiency, and 50 of 94 participants displayed good drop technique. Accuracy with eye drop performance was not related to QuickDASH scores (odds ratio (OR) [probability of successful administration per 10-point decrease in QuickDASH score]: 1.14, 95% CI: 0.89–1.45,p= .29). Success with drop administration efficiency was strongly associated with QuickDASH score (OR: 1.27, 95% CI: 1.04–1.54,p= .02), as was good drop technique (OR: 1.28, 95% CI: 1.05–1.56,p= .01), with lower (better) QuickDASH scores associated with better drop technique. There were no associations between upper extremity neurologic or musculoskeletal co-morbidities and observed good drop technique. The presence of either a neurologic or musculoskeletal upper extremity co-morbidity in a participant’s medical record was associated with a higher QuickDASH score.Conclusions: The QuickDASH survey may identify patients with eye drop administration difficulties so this population receives focused drop technique education and management strategies.Abbreviations: CPRS: Computerized Patient Records System; MSK: musculoskeletal; UE: upper extremity; VA: Veterans Affairs