EyeWorld India March 2016 Issue

Glaucoma treatment March 2016 27 EWAP SECONDARY FEATURE think they’re taking,” Dr. Harbin said. Sometimes it’s tempting to just look at the last note on the patient’s chart and ask if they are still taking the same drops—but you really have to hone in on the patient. Dr. Feldman said a discussion with the patient is important. You can also do an in-office trial and see how they are doing with their drops. “It’s not that you want to disbelieve all patients, but you have to—to a certain extent,” he said. Some patients have trouble remembering to take their drops. It’s important to try to tie that to a life event, Dr. Feldman said— something they’re already doing. It’s also important to keep the regimen simple, he said. “The less bottles they have to take, the better, and the less times a day they have to take them, the better.” New products and technologies Dr. Boland and his colleagues have carried out randomized trials to determine if people with non- adherence issues could be helped by some sort of reminder. Using automated telephone calls or text messages helped improve adherence to medications, he said. He added that it would be interesting to find a way to link electronic health records to medication reminders. “The one thing that’s still missing in all of this, however, is evidence,” Dr. Boland said. “Although it seems logical, we’ve not yet shown that if you’re not adherent, it is more likely that your glaucoma will get worse. It’s hard to follow people long enough to show this.” Dr. Harbin and his partner, Scott Pastor, MD, developed an app to try to address this problem. With the EyeDrops app, all types of drops are listed so patients can easily create a schedule, and the app will alert them when it’s time to take the drops, Dr. Harbin said. The EyeDrops app also helps patients keep track of their pressures. Sometimes if people can see their progress, it helps them become more adherent, he said. The app is helpful to physicians because it tracks medication use, and the patient can email this information to their doctor. “Over time, this becomes like a mini electronic medical record for glaucoma,” he said. There are a number of different types of apps now to address this. “I think ours is the most comprehensive,” Dr. Harbin said. “It also helps people with dry eyes.” EWAP Editors’ note: Dr. Harbin is the creator of the EyeDrops app. Drs. Boland and Feldman have no financial interests related to the article. Contact information Boland: boland@jhu.edu Feldman: robert.m.feldman@uth.tmc.edu Harbin: tomharbin@harbinbooks.com