In summer 2016, Moorfields Eye Hospital NHS Foundation Trust launched its pharmacy-led #knowyourdrops campaign. Its main objectives are to promote and encourage good eye drop compliance, provide support to patients, carers and staff regarding best techniques for administering eye drops, and demonstrate the range of available compliance aids and review their benefits for individual patients.
Support for eye drop techniques and compliance aids is often poorly considered or overlooked outside specialist ophthalmic units compared with inhalers, for example, where repeated time is usually spent assessing, reviewing and supporting technique. However, continual support with eye drop technique is essential since treatment does not always improve sight (often a motivator to use drops correctly) but can prevent disease progression (e.g. glaucoma).
With many patients having poor dexterity or vision, aiming eye drops correctly at the correct angle or squeezing plastic containers can be challenging. Furthermore, some patients perceive asking for support as wasting clinical time; others feel embarrassed to admit they cannot administer drops correctly or easily; and others do not even realise that they have poor technique. Overall, this can result in poor clinical outcomes or lead to financial losses with excessive dispensing when patients using several drops at a time to administer one drop accurately. Furthermore, polypharmacy can potentially be avoided if techniques are correct in the first instance.
All our patients are reviewed and counselled on good eye drop compliance and techniques, and continual support assessment is vital to aid compliance through a multidisciplinary team approach. The pharmacy and the clinical directorate team, therefore, decided to raise awareness of compliance and eye drop techniques, offer enhanced support and reduce any barriers to good compliance techniques and treatment failures through the #knowyourdrops campaign.
The campaign consists of a one-day event at each Moorfields site, of which there are around 25 satellites spread across London. We engaged with local clinical commissioning groups, GPs and our community partners, as well as local eye networks to help raise awareness and widen the invitation to support as many as possible. The campaign is advertised on the trust’s website and Twitter, with advice and information available, including a useful online video and an opportunity to live tweet any compliance-related questions.
The International Glaucoma Association (IGA) is greatly supporting #knowyourdrops since eye drop compliance, especially for glaucoma, is key for effective outcomes. We were honoured that the IGA’s chief executive officer came in person to support our first event, which strengthened the importance of the campaign and raised its profile.
Our lead consultant gained enthusiasm by opening the day with a message about compliance and eye drop techniques to all patients, and invited everyone to speak to the specialist ophthalmic pharmacy team and IGA for a review and advice. We integrated with the clinical team demonstrating best administration techniques, raising awareness of good compliance, and demonstrating various compliance aids available, which may be of benefit and not yet considered. We had an eye catching patient-facing stand set up in a prominent location with various leaflets and information, and we also sat with patients and carers in clinic and daycare, working alongside nurses and clinicians to help review treatments or side effects related to compliance issues. In addition, lunchtime workshops were delivered to all nursing, allied healthcare professionals, and clinicians in the unit, emphasising best eye drop techniques and assessments, and the range of compliance aids available.
Feedback so far is positive from patients, carers and staff, and we have a range of cases where this extra support has proven beneficial, including preventing surgery, reducing polypharmacy, reducing side effects experienced, and reducing the need for carers to assist throughout the day with administration. Several people reported that #knowyourdrops helped improve confidence administering eye drops and general techniques.
Lead pharmacist for satellite services and contracts
Associate chief pharmacist pharmacy regulation, strategy, procurement and satellite services
Moorfields Eye Hospital