점안약 차트를 통한 녹내장 환자의 점안약 사용법 및 순응도 향상
Eye Drop Chart for Improvement of Topical Eye Drops Administration and Adherence
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목적: 녹내장 안약을 점안하는 환자들을 대상으로 점안약 차트를 통한 순응도 향상을 알아보고자 한다. 대상과 방법: 녹내장 점안약을 사용 중인 환자를 대상으로 점안약 차트를 통해 점안 방법을 교육하였으며, 점안약 차트 사용 전과 사용 3개월 후 설문조사를 시행하여 녹내장 안약 점안의 수행성적(performance score)을 조사하였다. 점안약 차트 교육 전후 수행성적의 변화를 분석하고 사전조사 항목들과 검사 결과들의 수행성적과의 연관성을 분석하였다. 또한 수행성적에 따라 두 군으로 나누어 사전설문조사와 안약점안 방법 등의 수행성적 향상에 영향을 미치는 인자를 분석하였다. 결과: 47명의 환자가 연구대상자로 등록되었다. 점안약 차트 사용 전에는 안약점안 주체(p=0.002), 연평균 소득(p=0.036), 교육수준 (p=0.002)에 따라 수행성적의 유의한 차이를 보였다. 3개월간 점안약 차트 사용 후 평균 안압은 통계학적으로 유의미하게 감소하였고 (p=0.041), 수행성적의 향상도 이루어졌다(p=0.019). 다변수분석에서 활동영역(p=0.009), 안약점안 주체(p=0.001)가 수행성적의 향상에 유의한 상관관계를 보였다. 결론: 녹내장 환자에게서 점안약 차트 사용은 안압을 하강시킬 수 있는 효과적인 보조 방법이며, 안약 사용법을 환기시켜 순응도를 향상시키는 효과가 있다. 특히 본인이 직접 안약을 점안하는 환자, 주로 실내에서 활동하는 환자에서 순응도 향상에 효과적이었다.
Abstract
Purpose: To evaluate the efficacy of an eye drop chart and to determine the factors contributing to adherence enhancement using the eye drop chart. Methods: In this prospective study, enrolled glaucoma patients were educated on the administration of eye drops and use of the eye drop chart. They were required to complete a questionnaire on demographic characteristics and adherence. After 3 months, they completed a second questionnaire on adherence and satisfaction with the use of the eye drop chart. Changes in instillation behavior, relationships between performance scores and demographic characteristics, as well as factors contributing to the improvement of performance scores were analyzed. Results: Forty-seven patients were enrolled in this study. The performance scores were significantly better for those who administered the eye drops by themselves (p = 0.002), those with an annual income > 60 million won (p = 0.036), and patients with at least a college degree (p = 0.002). After using the eye drop chart for 3 months, the average intraocular pressure was significantly reduced (p = 0.041) and the performance score was improved (p = 0.019). The working area (p = 0.009) and eye drop applicator (p = 0.001) were correlated with performance score enhancement. Conclusions: The eye drop chart was a cost-effective tool for improving the adherence and instillation practices of glaucoma patients. Adherence was improved among patients with more indoor activity, and those who practiced self-instillation. It is expected that the respective conditions of such patients would be more efficiently improved in a clinical setting.
참고문헌 (31)
- Tatham AJ, "Eye drop instillation technique in patients with glaucoma", Eye, 27, pp.1293~1298 (2013)
- Gaynes BI, "Impact of administration angle on the cost of artificial tear solutions: does bottle positioning minimize wastage?", J Ocul Pharmacol Ther, 23, pp.196~201 (2007)
- Ritch R, "An improved technique of eye drop self-administration for patients with limited vision", Am J Ophthalmol, 135, pp.530~533 (2003)
- Kholdebarin R, "Multicenter study of compliance and drop administration in glaucoma", Can J Ophthalmol, 43, pp.454~461 (2008)
- Taylor SA, "Causes of non-compliance with drug regimens in glaucoma patients : a qualitative study", J Ocul Pharmacol Ther, 18, pp.401~409 (2002)
- Olthoff CM, "Noncompliance with ocular hypotensive treatment in patients with glaucoma or ocular hypertension an evidence-based review", Ophthalmology, 112, pp.953~961 (2005)
- Krilis M, "Digital eye drop instillation-a novel method", Aust Fam Physician, 42, pp.201~202 (2013)
- Solomon A, "Inadvertent conjunctival trauma related to contact with drug container tips : a masquerade syndrome", Ophthalmology, 110, pp.796~800 (2003)
- Nelson JD, "Corneal abrasion resulting from a unit dose artificial tear dispenser", Am J Ophthalmol, 103(3 Pt 1), pp.333~334 (1987)
- Aptel F, "The influence of disease severity on quality of eye-drop administration in patients with glaucoma or ocular hypertension", Br J Ophthalmol, 93, pp.700~701 (2009)
- Norell SE, "Improving medication compliance : a randomised clinical trial", Br Med J, 2, pp.1031~1033 (1979)
- Friedman DS, "Doctor-patient communication, health-related beliefs, and adherence in glaucoma results from the Glaucoma Adherence and Persistency Study", Ophthalmology, 115, pp.1320~1327 (2008)
- Cooper J, "Improving compliance with glaucoma eye-drop treatment", Nurs Times, 92, pp.36~37 (1996)
- Ashburn FS Jr, "Compliance with ocular therapy", Surv Ophthalmol, 24, pp.237~248 (1980)
- Newman-Casey PA, "The most common barriers to glaucoma medication adherence : a cross-sectional survey", Ophthalmology, 122, pp.1308~1316 (2015)
- Mira JJ, "A Spanish pillbox app for elderly patients taking multiple medications: randomized controlled trial", J Med Internet Res, 16, pp.e99~ (2014)
- Ho LY, "Effect of audible and visual reminders on adherence in glaucoma patients using a commercially available dosing aid", Clin Ophthalmol, 2, pp.769~772 (2008)
- McVeigh KA, "The eye drop chart : a pilot study for improving administration of and compliance with topical treatments in glaucoma patients", Clin Ophthalmol, 9, pp.813~819 (2015)
- Feng A, "Success of patient training in improving proficiency of eyedrop administration among various ophthalmic patient populations", Clin Ophthalmol, 10, pp.1505~1511 (2016)
- Sleath BL, "Patient-reported barriers to glaucoma medication access, use, and adherence in southern India", Indian J Ophthalmol, 57, pp.63~68 (2009)
- Kaona FA, "An assessment of factors contributing to treatment adherence and knowledge of TB transmission among patients on TB treatment", BMC Public Health, 4, pp.68~ (2004)
- Brunner-Ziegler S, "Predictors of participation in preventive health examinations in Austria", BMC Public Health, 13, pp.1138~ (2013)
- Dunlop S, "Socio-economic status and the utilisation of physicians’ services : results from the Canadian National Population Health Survey", Soc Sci Med, 51, pp.123~133 (2000)
- Lee SH, "Income disparities in the use of health screening services among university students in Korea: a cross-sectional study of 2479 participants in a university", Medicine, 95, pp.e3681~ (2016)
- Lee YY, "Barriers to cancer screening among medical aid program recipients in the Republic of Korea : a qualitative study", Asian Pac J Cancer Prev, 15, pp.589~594 (2014)
- Robin A, "Compliance and adherence in glaucoma management", Indian J Ophthalmol, 59(Suppl), pp.S93~96 (2011)
- Gupta R, "Evaluating eye drop instillation technique in glaucoma patients", J Glaucoma, 21, pp.189~192 (2012)
- Tsai T, "An evaluation of how glaucoma patients use topical medications : a pilot study", Trans Am Ophthalmol Soc, 105, pp.29~33 (2007)
- Ahn DH, "Factors affecting compliance with prescribed eyedrops for glaucoma", J Korean Ophthalmol Soc, 39, pp.2145~2151 (1998)
- 이민아, "녹내장환자의 안압하강제 점안 행태 분석", 대한안과학회지, 54(10), pp.1561~1566 (2013), 대한안과학회
- 신현영, "The Association between Socioeconomic Status and Adherence to Health Check-up in Korean Adults, Based on the 2010–2012 Korean National Health and Nutrition Examination Survey", Korean Journal of Family Medicine, 39(2), pp.114~121 (2018), 대한가정의학회