An App-based Instructional Platform to Improve Eye Drop Recall

Assessing the Effects of an In-office, Language-concordant App on Eye Drop Recall in Patients With Multi-drop Regimens

The goal of this interventional study is to assess whether an in-office, language-concordant instructional app improves drop regimen recall in a population of glaucoma patients who are on multi-drop regimens. Participants will be divided into two groups -- those who use the app and those who do not. The app will have narrated information regarding the drop regimen, a quiz to test understanding of the regimen, and will enable a graphical printout of the eye drops and schedule. At one month, both groups will be assessed on their eye drop regimen recall.

Specific Aim: To investigate whether a language-concordant instructional application improves drop regimen recall in population of glaucoma patients at a 1-month follow-up period. App features Pictorial representation of drops (color-coded) and schedule. Quiz to assess understanding of the regimen. Narrated instructions (language-concordant) on how and when (frequency and eye laterality) to take each drop. Graphical print-out of the regimen. Study design Study design: Randomized study, two groups: (1) patients that use the app, and (2) patients that do not use the app. Study population: Inclusion criteria: patients with primary open-angle glaucoma on at least 2 eye drops Exclusion criteria: patients taking additional prescribed eye drops for other eye conditions; patients diagnosed within the last 3 months; patients unable to self-administer eye drops Intervention: Use of an in-office app that has both graphical and verbal (language-concordant) instruction for how to use drops. Main outcome measure: Ability to correctly identify drops/regimen

The intervention is an in-office app that contains graphical and narrated information on a patient's specific drop regimen, and includes a quiz and a graphical print-out of their drop schedule. The patient will use the app during their clinic visit.

The standard arm will be the standard of care, which involves a provider explanation of their drop regimen (using a phone interpreter if needed).

App features (App will be used during the office visit): Pictorial representation of drops (color-coded) and schedule. Quiz to assess understanding of the regimen. Narrated instructions (language-concordant) on how and when (frequency and eye laterality) to take each drop. Graphical print-out of the regimen.

This will be assessed through questions querying which drops the patients are taking, the number of times they are taking each drop, and the laterality of each drop. Each answer/drop will be individual recorded, and then total number of correct answers will be divided by the total number of questions.

Overall medication adherence, assessed through the modified Morisky Adherence Scale, a widely published scale for general medication adherence

An 8 question survey (7 questions are yes/no, with the final question on a Likert scale) gauging overall medication adherence. Each question will be individually assessed (not summed into a cumulative score). The higher number of "yes" responses corresponds to a lower adherence score.

Inclusion Criteria: patients with a diagnosis of glaucoma (any type) drop regimen of at least 2 pressure-lowering drops languages supported at this time: English, Spanish, Cantonese Exclusion Criteria: concurrent eye conditions necessitating additional eye drops inability to self-administer eye drops inability to engage with app (either visual or other barrier)

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