Green Elspeth K Y, McGrath Orlaith, Steeples Laura, Ashworth Jane L
Manchester Royal Eye Hospital, Oxford Road, Manchester, M13 9WL, UK.
Division of Evolution and Genomic Sciences, University of Manchester, Manchester, UK.
Eye (Lond). 2024 Feb;38(3):572-577. doi: 10.1038/s41433-023-02736-0. Epub 2023 Nov 6.
BACKGROUND/OBJECTIVES: Uveitis in children and young people (CYP) is a rare but potentially debilitating condition. Steroid eye drops are the first step in treatment and poor compliance may result in vision-threatening complications. This study aims to measure compliance with prescribed eye drops prospectively in a child-specific manner.
SUBJECTS/METHODS: Patients aged 0-18 years attending a tertiary paediatric uveitis clinic using steroid drops were recruited. Both the CYP, and person with parental responsibility (PPR) completed questionnaires about compliance. A subgroup had bottles of Prednisolone 1% drops dispensed and weighed at the first appointment and reweighed at follow-up. The weight reduction was compared with expected weight change over the interval.
The study was completed by 42 patients of the 50 patients recruited. Thirty-one CYP and their respective PPR completed both questionnaires, 11 completed only one questionnaire (9 CYP, 2 PPR). Drop errors for all eye drops were reported more than "once a week" by 13/39 CYP (33.3%, 95% CI: 19.1%-50.2% of respondents), and 3/31 PPR (9.7%, CI: 19.1%-50.2% of respondents). Many PPR could not recall prescribed drop frequency (n = 13/31, 40.6%, CI: 23.7%-59.4% of respondents). Twelve patients had bottles weighed and returned. Insufficient weight reduction was found in 9 (75%, CI: 42.8%-94.5%). Within the eye drop weighing subgroup three participants (25%, CI: 5.5%-57.2%) used <50% the expected weight of drops.
This study demonstrated poor eye drop compliance in CYP with uveitis. Self-reported compliance was unreliable in this population. Worryingly, some patients miss more than 50% of drops and may suffer sub-optimal disease control.
背景/目的：儿童及青少年葡萄膜炎（CYP）虽罕见，但可能使人衰弱。类固醇眼药水是治疗的第一步，依从性差可能导致视力威胁性并发症。本研究旨在以前瞻性、针对儿童的方式衡量对处方眼药水的依从性。
受试者/方法：招募了在三级儿科葡萄膜炎诊所使用类固醇眼药水的0至18岁患者。儿童及青少年（CYP）以及有家长责任的人（PPR）均完成了关于依从性的问卷。一个亚组在首次就诊时领取并称重了1%泼尼松龙眼药水的瓶子，随访时再次称重。将重量减轻与该时间段内预期的重量变化进行比较。
招募的50名患者中有42名完成了研究。31名儿童及青少年（CYP）及其各自的有家长责任的人（PPR）完成了两份问卷，11人仅完成了一份问卷（9名CYP，2名PPR）。13/39名儿童及青少年（CYP，33.3%，95%置信区间：占受访者的19.1%-50.2%）和3/31名有家长责任的人（PPR，9.7%，置信区间：占受访者的19.1%-50.2%）报告所有眼药水的滴注错误超过“每周一次”。许多有家长责任的人（PPR）记不起规定的滴注频率（n = 13/31，40.6%，置信区间：占受访者的23.7%-59.4%）。12名患者的瓶子被称重并归还。9人（75%，置信区间：42.8%-94.5%）的重量减轻不足。在眼药水称重亚组中，三名参与者（25%，置信区间：5.5%-57.2%）使用的眼药水重量不到预期重量的50%。
本研究表明患有葡萄膜炎的儿童及青少年（CYP）对眼药水的依从性较差。在该人群中，自我报告的依从性不可靠。令人担忧的是，一些患者错过超过50%的滴注次数，可能导致疾病控制不佳。
