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Monitoring compliance to topical therapy in children and young people with uveitis

Eye volume 38, pages 572–577 (2024)Cite this article

Subjects

Abstract

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.

Results

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.

Conclusions

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.

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Fig. 1
Fig. 2: Reported eye drop error frequency and associations.
Fig. 3

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Data availability

The dataset from the current study is available from the corresponding author on reasonable request.

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Acknowledgements

The study was sponsored by Manchester Foundation Trust.

Funding

The study was funded through a grant awarded by the British and Irish Paediatric Ophthalmology and Strabismus Association (BIPOSA).

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Authors and Affiliations

  1. Manchester Royal Eye Hospital, Oxford Road, Manchester, M13 9WL, UK

    Elspeth K. Y. Green, Orlaith McGrath, Laura Steeples & Jane L. Ashworth

  2. Division of Evolution and Genomic Sciences, University of Manchester, Manchester, UK

    Laura Steeples & Jane L. Ashworth

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Contributions

EKYG—conception, study design, data collection, writing original draft and subsequent revisions. OM—data collection, writing review and editing. LS—data collection, writing review and editing. JLA—conception, supervision, study design, data collection, writing review and editing.

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Correspondence to Elspeth K. Y. Green.

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Green, E.K.Y., McGrath, O., Steeples, L. et al. Monitoring compliance to topical therapy in children and young people with uveitis. Eye 38, 572–577 (2024). https://doi.org/10.1038/s41433-023-02736-0

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