#knowyourdrops eye drop compliance campaign to achieve medicines optimisation in ophthalmology

Biographies

Sarah Thomas has worked across different sectors of Pharmacy and for several acute London Trusts.  She joined Moorfields in 2013 and leads on the delivery and development of the Trust’s clinical pharmacy services and medicines management initiatives for Moorfields satellites, as well as implementing new pharmacy services. Thomas has led on various initiatives to maximise patient care, including successfully establishing new pharmacies through working with external trusts and community partners. 

 

She is currently piloting pathways to implement innovative service models for patient experience, and is leading on increasing patient compliance though the #knowyourdrops campaign. She is an active member of various committees and project groups, and enjoys developing and enhancing services, providing her expert advice and support to all service users.

 

Fiona Chiu is a registered pharmacist and has worked across different sectors of pharmacy internationally in Canada, USA and the UK. In 2002, she first joined Moorfields Eye Hospital NHS Foundation Trust, a leading provider of eye health services in the UK and a world-class centre of excellence for ophthalmic research and education. Chiu currently works as the Associate Chief Pharmacist. She is also a visiting teacher practitioner at University of Bath. 

 

She has led the development of medicines management policies, training and practice research. She has been involved in numerous hospital projects by moderninsing pharmacy services and re-engineering the delivery of near-patient pharmaceutical care. #knowyourdrops campaign is one of her current projects, which aims to optimise medicines and patient compliance.

 

Summary

Moorfields Pharmacy has launched a Trustwide #knowyourdrops eye drop compliance campaign together with the International Glaucoma Association, to promote best eye drop techniques, raise awareness of why using eye drops correctly is essential, and educate patients/carers and health professionals on the various compliance aids available, to achieve medicines optimisation in ophthalmology. The numerous examples of improved care and quality of life for patients/carers is remarkable, confirming the campaign’s value to optimise medicines and patient outcomes.

 

Results

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 realise that they have poor technique. 

 

Overall, this can result in poor clinical outcomes or lead to financial losses with excessive dispensing due to patients using several drops at a time to administer one drop accurately. Furthermore, polypharmacy and repeat dispensing can potentially be avoided if techniques are correct in the first instance.

 

All our patients are reviewed and counselled on eye drop compliance and techniques, and continual support assessment is vital to aid compliance through a multidisciplinary team approach.  The pharmacy and clinical directorate team therefore decided to raise awareness of compliance and eye drop techniques, offer enhanced support and reduce barriers to good compliance techniques and treatment failures through the #knowyourdrops campaign.

 

The International Glaucoma Association is greatly supporting #knowyourdrops because eye drop compliance, especially for glaucoma, is key for effective outcomes. 

 

#Knowyourdrops consists of a one-day advertised event at each Moorfields site, of which there are around 25 satellites spread across London, with advice and information on the Trust’s website and Twitter – including a useful online video and an opportunity to live tweet compliance-related questions.  Engagement with local clinical commissioning groups, GPs, our community partners and local eye networks also helped raise further awareness.Our lead consultant opens the #knowyourdrops session by speaking about compliance and eye drop techniques to all patients/carers, inviting everyone to talk to us for a review and advice. 

 

We integrate with the clinical team by providing patients with a dedicated pharmacist-led patient consultation demonstrating best techniques, raising awareness of compliance, and demonstrating various compliance aids which may support treatment.  We have an eye catching patient-facing stand with information. During the pharmacist-led consultation, we review with patients/carers their treatment/side effects related to compliance issues. We also deliver interactive lunchtime workshops to all staff, emphasising best eye drop techniques and assessments, and available compliance aids.

 

Feedback has been very positive with 100% of patients/carers so far reporting #knowyourdrops has improved ability and confidence administering eye drops. The numerous cases including increased compliance, reduced polypharmacy, reduced side effects, and reduced need for carers to assist with administration, Overall, it demonstrates that the #knowyourdrops campaign helps achieve medicines optimisation in ophthalmology.