Medication Bottles Research Articles

An objective assessment of the variability in number of drops per bottle of glaucoma medication

BackgroundThe purpose of this study is to evaluate the number of eyedrops available per bottle of a variety of commonly prescribed glaucoma medications.MethodsSix bottles of each glaucoma medication were tested: three each in the vertical and horizontal orientations. Bottles were housed in a customized force gauge apparatus designed to mimic ballpoint fingertip contact with a bottle. At a standard rate, all drops were expressed from each bottle and counted with an automated drop counter. Simultaneously, bottle volume was measured and drop size and number were also estimated. The main outcome measures were: total number of drops, volume per bottle and drops per milliliter (mL) of glaucoma medication.ResultsA total of 192 bottles from 32 bottle designs and manufacturers were tested. Twenty-two of the 32 bottle designs had a significantly different mean number of drops in the vertical and horizontal positions, with 10 designs have more drops dispensed in the horizontal orientation and 12 in the vertical orientation. Six of the 32 bottle designs had a significantly different mean total bottle volume in the vertical and horizontal positions, with all designs having greater volume in the vertical position. An adjusted ratio of mean number of drops/mean bottle volume demonstrated a range from 20.9 drops/mL to 40.8 drops/mL.ConclusionsThere is significant variability in drops and volume available per bottle of glaucoma medication depending on both the bottle position and manufacturer. These data point to the need for circumspection in prescribing glaucoma medications and caution in evaluating therapeutic outcomes.

Pain severity and pharmacologic pain management among community-living older adults: the MOBILIZE Boston study

Concerns about polypharmacy and medication side effects contribute to undertreatment of geriatric pain. This study examines use and effects of pharmacologic treatment for persistent pain in older adults. The MOBILIZE Boston Study included 765 adults aged ≥70 years, living in the Boston area, recruited from 2005 to 2008. We studied 599 participants who reported chronic pain at baseline. Pain severity, measured using the Brief Pain Inventory (BPI) severity subscale, was grouped as very mild (BPI <2), mild (BPI 2-3.99), and moderate to severe (BPI 4-10). Medications taken in the previous 2weeks were recorded from medication bottles in the home interview. Half of participants reported using analgesic medications in the previous 2weeks. Older adults with moderate to severe pain were more likely to use one or more analgesic medications daily than those with very mild pain (49 versus 11%, respectively). The most commonly used analgesic was acetaminophen (28%). Opioid analgesics were used daily by 5% of participants. Adjusted for health and demographic factors, pain severity was strongly associated with daily analgesic use (moderate-severe pain compared to very mild pain, adj. OR 7.19, 95% CI 4.02-12.9). Nearly one third of participants (30%) with moderate to severe pain felt they needed a stronger pain medication while 16% of this group were concerned they were using too much pain medication. Serious gaps persist in pain management particularly for older adults with the most severe chronic pain. Greater efforts are needed to understand barriers to effective pain management and self-management in the older population.

In situ degradation of antibiotic residues in medical intravenous infusion bottles using high energy electron beam irradiation

This study reported an immediate approach for the degradation of three antibiotic (amoxicillin, ofloxacin, and cefradine) residues in medical intravenous infusion bottles (MIIBs) using high energy electron beam (HEEB) irradiation. The effects of irradiation doses, initial concentrations, initial pH, and scavengers of active radicals on the degradation of three antibiotic residues (ARs) were investigated, and the results displayed that 97.02%, 97.61% and 96.87% of amoxicillin, ofloxacin, and cefradine residues could be degraded in situ through HEEB irradiation respectively. Fourier transform infrared spectroscopy (FTIR) and high performance liquid chromatography-mass spectrometry (HPLC-MS) analysis demonstrated that ARs were mainly decomposed into inorganic ions and alkanes. Typically, the detailed degradation mechanism of ARs was also investigated, and the dominant active particle inducing the degradation of antibiotics during the HEEB irradiation process was demonstrated to be hydroxyl radical.

Effects of Skill Teaching of Oral Administration for Caregivers of Hospitalized Toddler on Dose Loss and Administration Behavior

Purpose: This study was designed to assess the effects of skill teaching of oral liquid medication on the dose loss and administering behavior. Methods: A nonequivalent control group no-synchronized design was used. 104 participants were assigned to one of two groups. A intervention group received a skill teaching and the control group received the conventional teaching about oral medication. Results: The mean amount of the dose loss by all participating caregivers was 23.3% of the prescribed dose and 61.5% of the caregivers showed dose loss more than 20% of the prescribed dose. Caregivers age (Exp=3.56, p=.017) and time taken for administration (Exp=7.97, p<.001) were related to more dose loss. Toddlers posture sitting in a stroller upon medication (Exp=.14, p=.009) and re-administering the remains after checking the medication bottle (Exp=.22, p=.040) influenced on reduction in dose loss. Before and after the skill teaching, a significant decrease in the dose loss was found in the high-viscous liquid medication only (t=-4.95, p<.001). The difference in the dose loss between the two groups were significant in the high-viscous liquid medication (t=4.95, p<.001). Also, administration behavior were significantly improved in the intervention group. Conclusion: The findings of this study showed that the skill teaching of oral liquid medication designed for toddlers caregivers was effective in reduction of dose loss and improvement in administering behaviors with confidence.

Markov Mixed Effects Modeling Using Electronic Adherence Monitoring Records Identifies Influential Covariates to HIV Preexposure Prophylaxis

Adherence is a major factor in the effectiveness of preexposure prophylaxis (PrEP) for HIV prevention. Modeling patterns of adherence helps to identify influential covariates of different types of adherence as well as to enable clinical trial simulation so that appropriate interventions can be developed. We developed a Markov mixed-effects model to understand the covariates influencing adherence patterns to daily oral PrEP. Electronic adherence records (date and time of medication bottle cap opening) from the Partners PrEP ancillary adherence study with a total of 1147 subjects were used. This study included once-daily dosing regimens of placebo, oral tenofovir disoproxil fumarate (TDF), and TDF in combination with emtricitabine (FTC), administered to HIV-uninfected members of serodiscordant couples. One-coin and first- to third-order Markov models were fit to the data using NONMEM® 7.2. Model selection criteria included objective function value (OFV), Akaike information criterion (AIC), visual predictive checks, and posterior predictive checks. Covariates were included based on forward addition (α= 0.05) and backward elimination (α= 0.001). Markov models better described the data than 1-coin models. A third-order Markov model gave the lowest OFV and AIC, but the simpler first-order model was used for covariate model building because no additional benefit on prediction of target measures was observed for higher-order models. Female sex and older age had a positive impact on adherence, whereas Sundays, sexual abstinence, and sex with a partner other than the study partner had a negative impact on adherence. Our findings suggest adherence interventions should consider the role of these factors.

Adherence with capecitabine: A population-based analysis based on prescription refill data.

Background Patient adherence is important with the increasing use of oral anticancer drugs. Recent studies reported different capecitabine adherence rates based on self-reporting and microelectronic monitoring of the medication bottle. Patient's awareness of being monitored may confound these results. Prescription records provide a larger and more objective dataset for adherence investigation. We report the use of computer algorithm and manual review of prescription and medical documentation to determine the rate of capecitabine adherence. Methods Two years of capecitabine prescription records from five ambulatory cancer centres were reviewed. Prescription data were extracted using a custom Java-based software tool to compare the predicted vs. actual dispensing date. The difference between the dates was the primary adherence measure (altered treatment date incident) and estimated using a computer algorithm and by manual review of medical charts. Results Of 4412 refill prescriptions, 45.2% was associated with an altered treatment date incident based on the initial computer algorithm. This was reduced to 29.5% after adjusting for clinic scheduling processes and 10.2% after manual chart review to adjust for valid reasons for delay. The reasons for altered treatment date incident were not identified in 52.2% of prescriptions. Conclusions Adherence rate of capecitabine based on refill data seem to be high and consistent with other findings based on patient self-report. Population analysis of prescription data with custom computer algorithm may identify trends in capecitabine adherence with some efficiency. Manual review would likely be required to verify these results. The accuracy of using altered prescription refill dates as an adherence measure requires further studies.

Folie à Trois: Prescribers', Pharmacists', and Patients' Shared Delusion of Medication Reconciliation.

Folie à Trois: Prescribers', Pharmacists', and Patients' Shared Delusion of Medication Reconciliation.

Measuring time utilization of pharmacists in the Birmingham Free Clinic dispensary.

BackgroundFree and charitable clinics are a critical part of America’s healthcare safety net. Although informatics tools have the potential to mitigate many of the organizational and service-related challenges facing these clinics, little research attention has been paid to the workflows and potential impact of electronic systems in these settings. In previous work, we performed a qualitative investigation at a free clinic dispensary to identify workflow challenges that may be alleviated through introduction of informatics interventions. However, this earlier study did not quantify the magnitude of these challenges. Time-motion studies offer a precise standard in quantifying healthcare workers’ time expenditures on clinical activities, and can provide valuable insight into system specifications. These data, informed by a lean healthcare perspective, provide a quality improvement framework intended to maximize value and eliminate waste in inefficient workflow processes.MethodsWe performed a continuous observation time-motion study in the Birmingham Free Clinic dispensary. Two researchers followed pharmacists over the course of three general clinic sessions and recorded the duration of specific tasks. Pharmacists were then asked to identify tasks as value-added or non-value-added to facilitate calculation of the value quotient, a metric used to determine a workflow’s level of efficiency.ResultsFour high-level workflow categories occupied almost 95 % of pharmacist time: prescription (Rx) preparation (39.8 %), clinician interaction (21.5 %), EMR operations (14.8 %), and patient interaction (18.7 %). Pharmacists invested the largest portion of time in prescription preparation, with 21.8 % of pharmacist time spent handwriting medication labels. Based on value categorizations made by the pharmacists, the average value quotient was found to be 40.3 %, indicating that pharmacists spend more than half of their time completing tasks they consider to be non-value-added.ConclusionsOur results show that pharmacists spend a large portion of their time preparing prescriptions, primarily the handwritten labeling of medication bottles and documentation tasks, which is not an optimal utilization of pharmacist expertise. The value quotient further supports that there are many wasteful tasks that may benefit from workflow redesign and health information technology, which could result in efficiency improvements for pharmacists.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1787-6) contains supplementary material, which is available to authorized users.

Building a new process: Nursing verification of pediatric oral chemotherapy.

199 Background: While team-based safety checks ensure safe prescribing of parenteral chemotherapy, oral chemotherapy is usually prescribed by a single clinician. With the growing use of oral chemotherapy, processes are needed to protect these vulnerable patients from prescription errors. Methods: A team of nurses, clinicians, pharmacists and administrators developed a new process and checklist for nursing verification of oral chemotherapy prescriptions at Dana-Farber’s pediatric neuro-oncology program. Prescriptions are verified against the treatment plan by two pediatric oncology nurses. The verification checklist includes drug, dose with any modifications, height and weight, laboratory values and patient instructions. When available, the prescription bottle is also verified. Data was collected over a three-month pilot period. Results: From 6/18/15-9/16/15, 56 prescription verifications occurred. Verification rate of on-site retail pharmacy filled prescriptions was 47% (32/68 prescriptions). Median time for verification was 20 minutes (IQR 15, 40) per nurse. Nurses identified problems outside of prescription verification, including missing prior authorizations and unclear treatment plans. Medication bottles were not routinely available for verification. One identified near miss would have resulted in an 80% under-dose of everolimus. Conclusions: Prescription verification by nursing in a pediatric oncology clinic was feasible. While it was successful in identification of one medication error before it reached the patient, only 47% of prescriptions were verified. Since prescription bottles are usually obtained after a visit, verification of the actual bottles will require new workflows, such as additional clinic visits or uploading a picture via the patient portal. Involving the nurse in the review of oral chemotherapy not only identified a prescription error, but also highlighted issues within other aspects of patients’ care, including inconsistent documentation of the treatment plan. The inclusion of nursing in the review and management of oral chemotherapy has the potential to improve safety and outcomes for these patients.

Inter-Rater Agreement in the Assessment of Video Recordings of Eye Drop Instillation by Glaucoma Patients.

PurposeTo create a standardized method for evaluating the video recordings of patients self-instilling eye drops and to determine the level of agreement of eye drop instillation efficacy, safety and efficiency ratings by three masked graders.DesignProspective cross-sectional study.Participants78 patients with open-angle glaucoma or ocular hypertension who had at least 6 months of experience with the use of eye drop medications.MethodsParticipants were video recorded while self-instilling artificial tears sequentially to both eyes. Three masked observers graded these video recordings on three criteria: efficacy (the determination of whether an eye drop was instilled on the ocular surface), safety (assessment of whether the tip of the medication bottle made contact with the ocular surface or eyelids), and efficiency (the number of eye drops expressed from the bottle).Main Outcome MeasuresAfter grading the video recordings based on efficacy, safety, and efficiency, kappa statistics were used to estimate inter-rater agreement.ResultsThe mean kappa level of agreement for efficacy, safety, and efficiency was 0.64 (95% confidence interval (CI), 0.42–0.87), 0.73 (95% CI, 0.58–0.88), and 0.62 (95% CI, 0.42–0.81), respectively.ConclusionsWe demonstrated good inter-rater reproducibility of the masked analysis of video recordings of patients self-instilling eye drops based on three criteria: efficiency, safety, and efficacy.

Using circular dot pattern code tag for medical information on the round type medical package

Administration of medicines is important issue for patient safety in medical applications. Especially, manufacture date and expiry date are very important. Medical applications have strong needs for embedded tags on medical bottles to facilitate medicine management. One-dimensional 1D barcode cannot represent the required information capacity. Two-dimensional 2D barcode and radio-frequency identification RFID systems can support information capacity. However, 2D barcode is hard to recognition, if 2D barcode tag is attached on curvature surface. RFID is 100 times more expensive than barcode systems and also it is difficult to embed RFID tags on curvature. In this paper, we propose circular dot pattern code CDPC tag for cylindrical and round type medical bottle identification and management. CDPC is based on topology of dot pattern code, and it is well suited to recognising tags in curvature environments. Experimental results show that CDPC outperformed 2D barcode in its recognition rate on curvature, including cylindrical and round shape.

Hypertensive Black Men's Perceptions of a Nurse Protocol for Medication Self-Administration.

A factor contributing to uncontrolled hypertension in older persons is medication nonadherence. Older Black men in a rural cardiology clinic were not taking blood pressure medication as prescribed resulting in uncontrolled hypertension. A nurse protocol to assist with self-administration of hypertensive medication was proposed to address the problem. This qualitative key informant study identified a purposive sample of 10 hypertensive Black men who were 65-70 years of age and nonadherent in taking their medication. The nurse conducted teaching sessions using the protocol to review evidence-based strategies for improving medication adherence. A follow-up phone call was done after 1 week. Participants were interviewed about their perceptions of taking hypertensive medication. The interviews were recorded, transcribed, and coded for themes using constant comparative analysis. Six themes emerged: Medication Bottle Guides Medication Usage, Confusion about Side Effects, Reasons for Not Taking Medications, New Behavior, Unchanged Behavior, and Discovery of Other Problems. The results showed that the nurse-administered protocol resulted in participants' changed attitudes about taking medication.

The application and effect evaluation of medical bottle opener box in clinical pharmacy

Objective To explore the application of medical bottle opener box (authorized patent for utility model) in nurses dispensing operations of opening the plastic bottle cap. Methods Put five self-made medical bottle opener box sample into the hospital emergency department for use. The nurses were divided into control group and experimental group according to the different way of open bottle caps; both groups were 33 nurses who did not turn out of emergency department 2 years nurses for a common object of study. The control group was the 33 nurses adopting the method of unarmed open medicine plastic bottle cap from April 2013 to March 2014. The experimental group was the 33 nurses with medical bottle opener box to open medicine plastic bottle caps from March 2014 to March 2015. The method of comparing two groups was to compare the nurse hands skin wear parts and wear symptoms for opening bottle caps, and make the nurses' satisfaction survey. Results For two groups, the nurse hands skin wear parts were in right hand, index finger and thumb; the number of nurses with finger thick skin in experimental group was lower than that in control group [21.2% (7/33) vs. 78.8%(26/33)], and there was significant difference,χ2=21.87, P <0.05.The number of pain [12.1% (4/33) vs. 54.5%(18/33)] and peeling [15.2% (5/33) vs.69.7%(23/33)] in experimental group were lower than those in control group, and there were significant differences,χ2= 13.36, 20.09,P < 0.05. The experimental group eliminated the blisters and scratches, avoided hand bleeding trauma. The nurses' overall satisfaction in experimental group was 93.9% (31/33), and 63.6% (21/33) in control group,and there was significant difference,χ2= 9.06, P <0.05. Conclusions Nurses using medical bottle opener box when opening the medicine bottle cap can relieve and reduce occupational injury on the finger skin of nurses, improve the nurse hand skin comfort, provide convenient operation safety, it is worth promoting. Key words: Medical bottle openerbox; Occupational injuries; Application; Evaluation

Book Review: Enchanted Objects: Design, Human Desire, and the Internet of Things, by David Rose

Objects: Design, Human Desire, and the Internet of Things. David Rose. New York, New York: Scribner, 2014. 304 pp. $20.50 hbk.Entrepreneur and MIT instructor David Rose has predicted the eventual emergence of four distinct technological layers of society: World, prosthetics, animism, and Enchanted Objects, for which his recent book-length advocacy has been subtitled Design, Human Desire, and the Internet of Things. Terminal World refers to our smartphone systems of today, expanded exponentially through cheaper, stronger, and more interconnected screens. Prosthetics, such as eyeglasses and hearing aids, will continue to be amplified, and animism (social robots) will interact with us in increasingly life-like and disorienting ways, as both kinds of developments raise questions about the essence of humanity. objects, though, offer reprieve and the most promise of the lot, Rose argues, because they create more humane and less distracting interfaces for the activities we want to do.He provides a variety of examples, including an jacket that gives the wearer a hug when a friend likes a Facebook post, a medical bottle cap that glows when the patient needs to take a pill, and the book's cover image of an Internetconnected umbrella that reads the weather report and lights up its handle when rain is expected. These ideas, and others, reflect Rose's experiences in his dual professional role as an industry pioneer and an academic. As an entrepreneur, he serves as CEO of Ditto Labs. And his book mentions many of his previous business successes, including his leadership of Vitality, a health-focused company specializing in wireless products. As an educator, he teaches a remarkable course on tangible user interfaces at MIT Media Lab, which also provides plentiful book fodder. As an author, though, he leans heavily in this book toward the marketing and promotional perspective of a start-up CEO by explaining why more objects, like the kinds his companies build, could be so marvelous, without also applying the critical and reasoned perspective of a skeptical scholar. He persistently characterizes iThings as lame and stupid without also addressing why billions of people have bought them and consider them indispensible. This approach, in turn, appears overstated for rhetorical effect, especially when considering the global adoption rate of those other technologies, and the comparatively uncritical perspectives offered about enchanted objects.Rose instead romanticizes those objects, at first through stories about his grandfather, an architect and woodworker, and his basement workshop, filled with hammers, screwdrivers, wrenches, clamps, and chisels. Yet he also inexplicably privileges some technological ideas, such as the magic of Dick Tracy's wrist communicator, over others, like the real functionalities of the glass-slabbed Apple Watch. Rose extolls the joys and value of the ordinary pen, for example, without acknowledging the iterative advancements of the pen technology from a stick dipped in ash to a quill to a fountain model to the Livescribe device that he raves about, connecting analog and digital forms. …

Trials and tribulations with electronic medication adherence monitoring in kidney transplantation.

Medication adherence in kidney transplantation is critical to prevent graft rejection. Testing interventions designed to support patients to take their prescribed medications following a kidney transplant require an accurate measure of medication adherence. In research, the available methods for measuring medication adherence include self-report, pill counts, prescription refill records, surrogate measures of medication adherence and medication bottles with a microchip-embedded cap to record bottle openings. Medication bottles with a microchip-embedded cap are currently regarded as the gold standard measure. This commentary outlines the challenges in measuring medication adherence using electronic medication monitoring of kidney transplant patients recruited from five sites. The challenges included obtaining unanimous stakeholder support for using this method, agreement on an index medication to measure, adequate preparation of the patient and training of pharmacy staff, and how to analyze data when periods of time were not recorded using the electronic adherence measure. Provision of this information will enable hospital and community pharmacists to implement approaches that promote the effective use of this adherence measure for optimal patient outcomes.

Safety first: Talk to patients about safe use, safe storage, and safe disposal of medications

Safety first: Talk to patients about safe use, safe storage, and safe disposal of medications

P18.06 Early antiretroviral therapy and pre-exposure prophylaxis for hiv prevention among female sex workers in cotonou, benin: early follow-up and adherence data

Introduction To assess the feasibility and usefulness of integrating treatment as prevention (TasP) and pre-exposure prophylaxis (PrEP) with Truvada ® to the combination prevention package offered to female sex workers (FSWs) in Cotonou, we are currently carrying out a demonstration project on these two HIV preventive strategies among FSWs. Methods We are currently recruiting 100 HIV-infected FSWs for TasP and 250 HIV-negative FSWs for PrEP (one-year recruitment period, followed by an additional one year of follow-up). The actual recruitment visit is preceded by a screening visit two weeks earlier in order to determine the HIV status and assess other eligibility criteria. Through follow-up visits at day 14 and then quarterly, we closely monitor treatment adherence, using various tools including a pill count strategy. For the latter, we ask participants to bring in their bottles of medication at each visit. We report here on the first five months of the clinical phase of the study. Results From 18 th september 2014 to 28 th February 2015, we screened 154 FSWs and out of them, 85 and 34 were recruited in the PrEP and TasP arms, respectively. Median age of the participants was 34 years and 38% were from Benin, whereas the other were from surrounding countries. To 28 th February, the overall retention rate in the study was 100% for TasP and 85% for PrEP. Most drop-outs were due to mobility and leaving the sex trade. Adherence to PrEP was 84% according to pill count. Conclusion The retention rate in the study is encouraging so far. Adherence levels, although estimated through a simple method that could lead to overestimations, could be improved and a multi-faceted adherence education program is now implemented. The availability of Truvada ® blood levels will allow an objective assessment of adherence, a highly crucial parameter for the success of eventual PrEP programs. Disclosure of interest statement This study is funded by the Bill and Melinda Gates Foundation, and Truvada® for pre-exposure prophylaxis is provided free of charge by Gilead Sciences, Inc.

How glaucoma patient characteristics, self-efficacy and patient-provider communication are associated with eye drop technique.

The objective of this study was to examine the extent to which patient characteristics, eye drop technique self-efficacy, and ophthalmologist-patient communication about eye drop administration are associated with glaucoma patients' ability to instil a single drop, have the drop land in the eye, and avoid touching the applicator tip of the medication bottle to the eye or face while self-administering eye drops. Glaucoma patients (n = 279) were recruited from six ophthalmology clinics. Medical visits were videotape-recorded. Afterwards, patients were interviewed and demonstrated administering an eye drop on a videotaped-recording. Generalized estimating equations were used to analyse the data. Ophthalmologists provided eye drop administration instruction to 40 patients. Patients with more years of education were significantly more likely to both instil a single drop (P = 0.017) and have the drop land in their eye (P = 0.017). Women were significantly more likely to touch the applicator tip to their eyes or face (P = 0.014). Patients with severe glaucoma (P = 0.016), women (P = 0.026), and patients who asked at least one eye drop administration question (P = 0.001) were significantly less likely to instil a single drop. Patients with arthritis were significantly less likely to have the drop land in their eye (P = 0.008). African American patients were significantly less likely to touch the applicator tip to their eyes or face (P = 0.008). Some glaucoma patients have a difficult time self-administering eye drops. As so few patients received eye drop administration instruction from their providers, there is an opportunity for pharmacists to complement care.

Ability of Bottle Cap Color to Facilitate Accurate Patient–Physician Communication Regarding Medication Identity in Patients with Glaucoma

To determine the accuracy of patient-physician communication regarding topical ophthalmic medication use based on bottle cap color, particularly among individuals who may have acquired color vision deficiency from glaucoma. Cross-sectional, clinical study. Patients aged ≥18 years with primary open-angle, primary angle-closure, pseudoexfoliation, or pigment dispersion glaucoma, bilateral visual acuity of ≥20/400, and no concurrent conditions that may affect color vision. A total of 100 patients provided color descriptions of 11 distinct medication bottle caps. Color descriptors were then presented to 3 physicians. Physicians matched each color descriptor to the medication they thought the descriptor was describing. Frequency of patient-physician agreement, occurring when all 3 physicians accurately matched the color descriptor to the correct medication. Multivariate regression models evaluated whether patient-physician agreement decreased with degree of better-eye visual field (VF) damage, color descriptor heterogeneity, or color vision deficiency, as determined by the Hardy-Rand-Rittler (HRR) score and Lanthony D15 color confusion index (D15 CCI). Subjects had a mean age of 69 (±11) years, with VF mean deviation of-4.7 (±6.0) and-10.9 (±8.4) decibels (dB) in the better- and worse-seeing eyes, respectively. Patients produced 102 unique color descriptors to describe the colors of the 11 bottle caps. Among individual patients, the mean number of medications demonstrating agreement was 6.1/11 (55.5%). Agreement was less than 15% for 4 medications (prednisolone acetate [generic], betaxolol HCl [Betoptic; Alcon Laboratories Inc., Fort Worth, TX], brinzolamide/brimonidine [Simbrinza; Alcon Laboratories Inc.], and latanoprost [Xalatan; Pfizer, Inc., New York, NY]). Lower HRR scores and higher D15 CCI (both indicating worse color vision) were associated with greater VF damage (P < 0.001). Extent of color vision deficiency and color descriptor heterogeneity significantly predicted agreement in multivariate models (odds of agreement= 0.90 per 1 point decrement in HRR score, P < 0.001; odds of agreement= 0.30 for medications exhibiting high heterogeneity [≥11 descriptors], P= 0.007). Physician understanding of patient medication use based solely on bottle cap color is frequently incorrect, particularly in patients with glaucoma who may have color vision deficiency. Errors based oncommunication using bottle cap color alone may be common and could lead to confusion and harm.

Videographic Assessment of Glaucoma Drop Instillation.

ABSTRACTPurpose: To assess the effect of patient education on videotaped topical instillation of artificial tear drops on subsequent topical instillation.Materials and methods: Forty-five patients, who had been using glaucoma drops for at least 6 months and with a best-corrected visual acuity of 20/100 or better, were studied. The patients were asked to instill an artificial tear drop using their accustomed technique while being video recorded. The patients viewed the recordings, and the errors in their drop instillation method were pointed out. This was followed by an educational session on proper drop instillation technique. After 30 minutes, patients were videotaped instilling drops to ascertain the effect of the educational session. The variables compared were: number of drops instilled, number of drops reaching the ocular surface, and the number of times the tip of the medication bottle touched the eye or ocular adnexa.Results: Before the instruction session, patients squeezed an average of 1.5 ± 0.9 drops from the bottle, and the average number of drops reaching the conjunctival fornix was 0.9 ± 0.7. The tip of the bottle touched the ocular adnexa in 29/45 (64.4%) patients. After the education session, the patients squeezed an average of 1.2 ± 0.5 drops and an average of 1.2 ± 0.4 drops reached the conjunctival fornix. The tip of the bottle touched the ocular adnexa in 13/45 (28.9%) patients. With proper instructions, the percentage of patients that instilled just one drop on the eye increased from 66 to 82%.Conclusion: A single educational session on the proper use of topical drops improves the successful instillation of eye drops. However, it was not determined whether the patients will retain the improved instillation technique for long-term or if the intervention results in only a short-term improvement.How to cite this article: Lazcano-Gomez G, Castillejos A, Kahook M, Jimenez-Roman J, Gonzalez-Salinas R. Video-graphic Assessment of Glaucoma Drop Instillation. J Curr Glaucoma Pract 2015;9(2):47-50.