{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T10:18:51Z","timestamp":1787653131671,"version":"build-2736575974"},"reference-count":23,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Ophthalmology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To compare patient education with a medical device as strategies to improve eye drop instillation in glaucoma patients and to assess their effects on intraocular pressure (IOP) control, treatment adherence, self-perceived competence, and observer-rated technique.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>In this randomized, crossover trial, 45 patients with primary open-angle glaucoma were assigned to group A (education only, n\u2009=\u200922) or group B (device, n\u2009=\u200923). After 60 days, the groups crossed over to the alternate intervention. IOP, ocular surface staining, treatment adherence, and instillation techniques were evaluated over 120 days using questionnaires and observer assessments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      By the second assessment, mean right-eye IOP was lower with the device (15.8 mmHg vs. 20.1 mmHg;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.05), and this reduction persisted after crossover. In contrast, the education group showed a nonsignificant trend toward worsening IOP (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&gt;\u20090.05), possibly influenced by baseline differences. Overall, the device achieved a 35% reduction in IOP compared with 23% for education alone. Adherence also improved markedly with the device: 71.1% of patients reported better compliance, versus only 2.2% in the education group (26.7% reported no change). Observer assessments supported these findings, with 91% of device users demonstrating correct instillation technique compared with 32% in the education group. Overdosing was more common in the education group (42% instilled more than one drop vs. 9% with the device). Patients additionally rated the device as easier and safer to use\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The medical device outperformed education alone in improving instillation technique, IOP control, and treatment adherence while also reducing overdosing.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11206721261428839","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T12:44:22Z","timestamp":1774442662000},"page":"1363-1372","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and adherence to glaucoma treatment depending on eye drop application technique: A crossover randomized clinical trial"],"prefix":"10.1177","volume":"36","author":[{"given":"Fernando","family":"Aguirre-Balsalobre","sequence":"first","affiliation":[{"name":"San Juan University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1546-4807","authenticated-orcid":false,"given":"David P.","family":"Pi\u00f1ero","sequence":"additional","affiliation":[{"name":"Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Consuelo","family":"Serra-Verd\u00fa","sequence":"additional","affiliation":[{"name":"San Juan University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Hernandez-Pardines","sequence":"additional","affiliation":[{"name":"San Juan University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Encarnaci\u00f3n","family":"Mengual-Verd\u00fa","sequence":"additional","affiliation":[{"name":"San Juan University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Garcia-Conca","sequence":"additional","affiliation":[{"name":"San Juan University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,25]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/archophthalmol.2009.96"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/ICU.0000000000000451"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.74.8.477"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/1376020"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/IJG.0b013e31820bd2e1"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2010.03.040"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1185\/03007995.2013.833898"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.5935\/0004-2749.20170058"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2008.156125"},{"key":"e_1_3_2_11_2","first-page":"594","article-title":"Factors affecting eye drop instillation in glaucoma patients with visual field defect","volume":"26","author":"Naito T","year":"2016","unstructured":"Naito T, Namiguchi K, Yoshikawa K, et al. 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Impact of the support, educate, empower personalized glaucoma coaching program pilot study on eye drop instillation technique and self-efficacy. 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