Stylianos A Kandarakis MD 12 Neel Kumar MD 12 Winston Garris 12 Robert Routh 12 Allison Babuich 12 Nick Frame 12 Joshua Groetsch 1 H Sprague Eustis 2 Louisiana State University Health Science Center Department of Ophthalmology New Orleans LA ID: 564965
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Slide1
“Postoperative medication compliance before and after the introduction of medication administration instruction sheet in patients who underwent cataract extraction surgery”
Stylianos A Kandarakis M.D.1,2, Neel Kumar M.D. 1,2, Winston Garris1,2, Robert Routh1,2, Allison Babuich1,2, Nick Frame1,2 , Joshua Groetsch1,, H. Sprague Eustis2 Louisiana State University Health Science Center, Department of Ophthalmology New Orleans , LA1; Ochsner Health System, New Orleans , LA2
EQUIP Project 2012-2013Ophthalmology Department LSU/OchsnerSlide2
1.
To assess the postoperative medication compliance in patients who underwent cataract extraction surgery in LSU System Hospitals. 2. To determine whether the introduction of medication administration instruction sheet will improve the postoperative medication compliance in patients who underwent cataract extraction surgery in LSU System Hospitals.
PurposesSlide3
Double-site, prospective, observational study.
The study group consisted of one hundred twenty patients who had recent (less than 30 days) cataract extraction surgery Patients were divided into two groups (n=60). In Group A, compliance of medication use was recorded on postoperative day 7 and 30. In Group B, the patients were given a set of instructions after surgery and compliance was similarly recorded.MethodsSlide4
YOUR POSTOPERATIVE MEDICATIONS
Start taking this medication 4 times/ a day for the 1
st weekThen start tapering as following:3 times/ a day for the 2nd week2 times/ a day for the 3rd week1 time/ a day for the 4th weekAnd then stop(medication comes in white or pink top) Start taking this medication 4 times/ a day for the 1st week, then stop (medication comes in tan/beige top) Start taking this medication 4 times/ a day for the 1st week, then stop (medication comes in grey top)
Instruction SheetSlide5
POST-OP COMPLIANCE
DAY 1 YES NODAY 7 YES NO
DAY 30 YES NONon-adherence was defined as: Omission of drug use for more than 1 day or 2. Omission of the use of one of the three postoperative medications
Recording ComplianceSlide6
In Group A (without instruction sheet), 46 out of 60 patients were compliant and compliance was recorded at 80%. In Group B (with instruction sheet), 52 out of 60 patients were compliant and compliance was recorded at 90%.
ResultsSlide7
In Group A the compliance 7 days and 30 days after surgery was recorded at 80% (24/30) and 73.3% (22/30) accordingly.
In Group B the compliance 7 days and 30 days after surgery was recorded at 90% (27/30) and 83.3% (25/5) accordingly.
ResultsSlide8
Compliance
Group A
(without instruction sheet)Group B
(with instruction sheet)
p value
OR
Days 7
24/30 (80%)
27/30 (90%)
0.47 (ns
)
0.44
Days 30
22/30 (73.3%)
25/30 (83.3%)
0.53 (ns
)
0.55
Total
46/60 (76.7%)
52/60 (86.7%)
0.24 (ns
)
0.51
p value
OR
0.76 (ns
)
1.4545
0.71 (ns
)
1.8
No statistically significant difference in compliance was evident when comparing the two different Groups.
No statistically significant difference in compliance was evident when comparing compliance in postoperative day #7 and day #30 between Group A and Group B.
ResultsSlide9
Medication compliance is a crucial parameter in preventing and treating ophthalmologic diseases.
Increasing medication compliance remains a challenge for most ophthalmologists and multiple measures have been used (reminders, pictograms, educational videos). In our study using patient’s self report, the compliance before and after the introduction of medication administration instruction sheet, was recorded at 80% and 90% accordingly.
No significant difference was evident, though a trend for increase compliance was evident in the Group that the instruction sheet was used. A trend for reduced compliance was also noticed depending on the duration of postoperative period (7 days postop vs 30 days postop) in both Groups.
ConclusionsSlide10
1)Compliance barriers in glaucoma: a systematic classification.
Tsai JC, McClure CA, Ramos SE, Schlundt DG, Pichert JW.Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA. 2)Effects of pictograms in educating 3 distinct low-literacy populations on the use of postoperative cataract medication. Braich PS,Almeida DR,Hollands S, Coleman MTRoss University School of Medicine, Dominica, West Indies.
3)Impact of a health communication intervention to improve glaucoma treatment adherence. Results of the interactive study to increase glaucoma adherence to treatment trial.Glanz K, Beck AD, Bundy L, Primo S, Lynn MJ, Cleveland J, Wold JA, Echt KV.Perelman School of Medicine and School of Nursing, University of Pennsylvania, Philadelphia, USA.4)Effect of written instructions on accuracy of self-reporting medication regimen in glaucoma patients.Kharod BV, Johnson PB, Nesti HA, Rhee DJ.
William and Anna Goldberg Glaucoma Service, Wills Eye Hospital, Philadelphia, PA, USA.
References