Department of Medicine, Duke University School of Medicine , Durham , NC , USA.
Department of Ophthalmology, Duke University School of Medicine , Durham , NC , USA.
Curr Eye Res. 2019 Oct;44(10):1150-1156. doi: 10.1080/02713683.2019.1625405. Epub 2019 Jun 11.
: To determine if an upper extremity functional survey may identify which patients will have eye drop administration difficulty. : Participants with glaucoma treated at a Veterans Affairs Eye Clinic who did not self-report 100% medication adherence were enrolled in a cross-sectional study. Participants were scored on their observed ability to place a drop into the eye (accuracy) and express no more than one drop from the bottle (efficiency). Successful execution of both of these conditions was defined as good drop technique. Participants also completed the QuickDASH, a validated upper extremity functional survey, with higher scores indicating worse disability. We hypothesized participants with lower QuickDASH scores would have an increased probability of observed success with drop administration measures. Diagnoses of upper extremity co-morbidities were abstracted from participants' medical records and clustered into diagnostic groups of either neurologic or musculoskeletal etiologies. : When observed, 80 of 94 participants displayed successful accuracy, 58 of 94 participants displayed successful efficiency, and 50 of 94 participants displayed good drop technique. Accuracy with eye drop performance was not related to QuickDASH scores (odds ratio (OR) [probability of successful administration per 10-point decrease in QuickDASH score]: 1.14, 95% CI: 0.89-1.45, = .29). Success with drop administration efficiency was strongly associated with QuickDASH score (OR: 1.27, 95% CI: 1.04-1.54, = .02), as was good drop technique (OR: 1.28, 95% CI: 1.05-1.56, = .01), with lower (better) QuickDASH scores associated with better drop technique. There were no associations between upper extremity neurologic or musculoskeletal co-morbidities and observed good drop technique. The presence of either a neurologic or musculoskeletal upper extremity co-morbidity in a participant's medical record was associated with a higher QuickDASH score. : The QuickDASH survey may identify patients with eye drop administration difficulties so this population receives focused drop technique education and management strategies. : CPRS: Computerized Patient Records System; MSK: musculoskeletal; UE: upper extremity; VA: Veterans Affairs.
为了确定上肢功能调查是否可以确定哪些患者滴眼剂给药有困难。
在退伍军人事务部眼科诊所接受治疗但未报告 100%药物依从性的青光眼参与者参加了一项横断面研究。参与者被评估其将一滴眼药水滴入眼睛的能力（准确性）和从瓶中滴出不超过一滴的能力（效率）。成功执行这两个条件被定义为良好的滴眼技术。参与者还完成了经过验证的上肢功能调查 QuickDASH，得分越高表示残疾越严重。我们假设 QuickDASH 得分较低的参与者观察到滴眼剂给药措施成功的可能性增加。上肢合并症的诊断从参与者的病历中提取出来，并聚类为神经或肌肉骨骼病因的诊断组。
观察到 94 名参与者中有 80 名显示出准确性成功，94 名参与者中有 58 名显示出效率成功，94 名参与者中有 50 名显示出良好的滴眼技术。眼部滴药表现的准确性与 QuickDASH 评分无关（每降低 10 分 QuickDASH 评分的成功给药概率的比值比（OR）：1.14，95%CI：0.89-1.45， = 0.29）。滴注效率的成功与 QuickDASH 评分密切相关（OR：1.27，95%CI：1.04-1.54， = 0.02），良好的滴眼技术也如此（OR：1.28，95%CI：1.05-1.56， = 0.01），较低（较好）的 QuickDASH 评分与较好的滴眼技术相关。上肢神经或肌肉骨骼合并症与观察到的良好滴眼技术之间没有关联。参与者病历中存在神经或肌肉骨骼上肢合并症与较高的 QuickDASH 评分相关。
QuickDASH 调查可能会识别出滴眼剂给药困难的患者，以便为这部分人群提供集中的滴眼技术教育和管理策略。
计算机化患者记录系统；MSK：肌肉骨骼；UE：上肢；VA：退伍军人事务部。
