Quantifying and Understanding Glaucoma Eye Drop Medication Instillation and Adherence

量化和了解青光眼滴眼剂药物滴注和依从性

• 批准号: 10338660
• 负责人: Stephen Matthew Cain
• 金额: $ 65.8万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-01 至 2026-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10338660
• 关键词: Adherence; Adult; Affect; African American; African American population; Age; Aging; Agreement; Algorithms; American; Behavior; Biomechanics; Blindness; Caring; Cellular Phone; Classification; Clinical; Clinical Research; Communication; Computers; Consumption; Controlled Environment; Data; Development; Diagnosis; Discrimination; Drops; Educational process of instructing; Effectiveness; Elderly; Engineering; Event; Eye; Eyedrops; Feedback; Glaucoma; Goals; Hand functions; Head; Home; Impairment; Individual; Intervention; Interview; Knowledge; Limb structure; Link; Machine Learning; Measures; Medical Care Team; Monitor; Movement; Outcome; Participant; Patients; Persons; Pharmaceutical Preparations; Physicians; Population; Positioning Attribute; Posture; Predictive Factor; Probability; Proprioception; Provider; Research; Sampling; Schedule; Self Management; System; Tactile; Technology; Testing; Text; Text Messaging; Time; United States; Vision; Work; acceptability and feasibility; base; body position; design; diaries; effective therapy; ethnic minority; improved; intrinsic motivation; low socioeconomic status; medication compliance; microsensor; motion sensor; novel; patient oriented; performance tests; personalized intervention; portability; preservation; prevent; programs; prototype; racial and ethnic; sensor; success; tool; usability; user centered design; user-friendly; wearable sensor technology

PROJECT ABSTRACT Despite the availability of effective treatments, glaucoma remains the leading cause of irreversible blindness among African American adults and the second leading cause of irreversible blindness in the United States. Non-adherence to daily prescribed eye drop medications – the treatment for 89% of glaucoma patients - is a key modifiable driver of vision loss in glaucoma. In current practice, patients are diagnosed with glaucoma and simply given a prescription, with only 1 in 8 prescribing physicians teaching patients how to use eye drops. 40% of glaucoma patients do not take their daily eye drop medication according to the prescribed schedule. 20% of glaucoma patients do not succeed in getting drops into their eyes. Glaucoma primarily affects older adults who may have aging-related sensorimotor deficits that impair successful medication instillation. Our long term goal is to develop a comprehensive system to monitor medication use, quantify whether administered drops are successfully delivered, communicate usage data to the patient’s health care team, and coach each patient on how to use their eye drop medications. Our central hypothesis is that by identifying the biomechanical and sensorimotor factors associated with eye drop instillation success – whether a drop gets in the eye – we can develop more effective, personalized intervention strategies to improve medication adherence and increase instillation success. Our overall objectives are to: 1) use motion sensors that measure the biomechanical movement of instilling eye drops, together with tests of sensorimotor abilities, to identify factors that result in successful eye drop instillation success among older adults; and 2) use input from older participants to design a comprehensive, simple, and user-friendly Eye Drop Adherence Monitoring System (EAMS). The EAMS will consist of a low-power, portable, on-bottle sensor and a cellular-linked communication base station to identify remotely when an eye drop was dispensed and record the probability of successful instillation. The EAMS will also integrate a personalized text message program tailored to individual adherence levels. Following development, we will test the EAMS to assess the agreement between EAMS classification of an eye drop use event and eye drop instillation success and an eye drop use diary and video- recorded eye drop instillation. We will assess the acceptability of the system among a sample of glaucoma patients through qualitative interviews. Impact: Our interdisciplinary team will gain and share new knowledge about the biomechanics of eye drop instillation and the impact of the sensorimotor deficits of aging on eye drop medication use. This knowledge will inform the development of a scalable Eye Drop Adherence Monitoring System (EAMS) that can be used clinically to improve the effectiveness of glaucoma care in preventing vision loss. This tool will be able to assess adherence to eye drop medications in both the clinical and research settings. A deeper understanding will inform patient-centered approaches to self-management support and aid in closing outcomes disparities in glaucoma – and every other condition needing eye drop medications.

项目摘要 尽管有有效的治疗方法，青光眼仍然是导致不可逆失明的主要原因 在非裔美国成年人中，这是导致美国不可逆转失明的第二大原因。 不遵守每日处方的滴眼药（89% 的青光眼患者接受的治疗）是一个问题 青光眼视力丧失的关键可改变驱动因素。在目前的实践中，患者被诊断患有青光眼 只是开出处方，只有八分之一的处方医生教患者如何使用眼药水。 40% 的青光眼患者没有按照规定的时间表每天服用眼药水。 20% 的青光眼患者无法成功滴入眼药水。青光眼主要影响老年人 可能患有与衰老相关的感觉运动缺陷的成年人，该缺陷会影响成功的药物滴注。我们的 长期目标是开发一个全面的系统来监测药物使用情况，量化是否 成功输送滴剂，将使用数据传达给患者的医疗团队，以及 指导每位患者如何使用眼药水。我们的中心假设是，通过识别 与滴眼液滴注成功相关的生物力学和感觉运动因素——滴眼液是否进入 眼睛——我们可以制定更有效、个性化的干预策略来改善药物治疗 坚持并提高滴注成功率。我们的总体目标是：1）使用运动传感器 测量滴眼药水的生物力学运动，并测试感觉运动能力，以 确定导致老年人成功滴眼药水的因素； 2）使用来自的输入 年长参与者设计一个全面、简单且用户友好的滴眼剂依从性监测 系统（EAMS）。 EAMS 将由一个低功耗、便携式、瓶装传感器和一个蜂窝连接的传感器组成 通信基站远程识别何时滴眼药水并记录滴眼药水的概率 成功灌输。 EAMS 还将集成针对个人量身定制的个性化短信程序。 遵守水平。开发完成后，我们将测试 EAMS 以评估 EAMS 之间的协议 滴眼剂使用事件和滴眼剂滴注成功的分类以及滴眼剂使用日记和视频- 记录滴眼液。我们将评估该系统在青光眼样本中的可接受性 通过定性访谈对患者进行评估。影响：我们的跨学科团队将获得并分享新知识 关于滴眼液滴注的生物力学以及衰老感觉运动缺陷对滴眼液的影响 药物使用。这些知识将为可扩展的滴眼剂依从性监测的开发提供信息 可用于临床提高青光眼护理预防视力有效性的系统（EAMS） 损失。该工具将能够评估临床和研究中对滴眼剂药物的依从性 设置。更深入的理解将为以患者为中心的自我管理支持和援助方法提供信息 最后，青光眼以及所有其他需要滴眼药的疾病的结果存在差异。