Improved monitoring of adherence with patching treatment using a microsensor and Eye Patch Assistant

Abstract

Use of a microsensor has been suggested to monitor patching adherence. Application has been limited because the microsensor's small size makes it easy to lose and a swallowing risk. We designed the Eye Patch Assistant (EPA) to hold the small microsensor in place and reduce the risk of loss or swallowing. This study reports the accuracy, precision, ease of use, and comfort for patching with EPA (patch+EPA) to monitor adherence. Adults (N=13) wore an adhesive patch alone or a patch+EPA for 2hours each, recorded wear time, and completed an ease of use/comfort questionnaire; 30 children wore a patch or patch+EPA and completed the questionnaire. Sensor sampling interval was every 5minutes or every 1minute. Sensor accuracy and precision were evaluated by Bland-Altman analysis and 95% limits of agreement, and questionnaire scores compared by Wilcoxon tests. With 5-minute sampling, we found excellent accuracy for adults (mean actual vs recorded time difference, 1.4minutes) and children (mean difference, -0.9min). We found high precision for both adults and children (95% limits of agreement half widths of 6.4minutes and 1.9minutes, respectively). In adults, the ease of use score for the patch+EPA was lower than the patch (P<0.01), but the comfort score for the patch+EPA was higher (P<0.01). For children, scores did not differ significantly. The patch+EPA functioned well between 45° and 82°F. The patch+EPA was well accepted and monitored adherence accurately and precisely.