b-drop: Promoting Topical Medical Adherence

The emotional challenges associated with daily eye drop administration often include frustration and uncertainty, particularly due to the long-term nature of treatment. Many patients feel that, despite adhering to a twice-daily regimen for weeks or months, they experience no noticeable improvement. This lack of perceived progress can reduce confidence and trust in their treatment regimen. In glaucoma management, topical medications do not improve vision; instead, they prevent further deterioration and delay the need for intraocular pressure-lowering surgery. Understanding this is essential to supporting ongoing adherence motivation.

Innovating for trust, confidence and agency within the eye drop regimen can help reduce feelings of shame or embarrassment when adherence becomes difficult. Supporting a sense of agency reminds users that their treatment is achievable and that they maintain control over their progress. By reminding users how many eye drops have been successfully administered and when doses are due, confidence is reinforced and adherence to treatment can be improved.

When users are unable to independently adhere to their eye drop regimen, this can negatively impact their dignity and sense of agency within the treatment process. The concept of locus of control recognises that patients are more likely to adhere to treatment when they feel self-determined and capable, with strong agency over their own health outcomes. By designing solutions that address both the emotional and physical barriers to adherence, users can feel empowered, supported, and more motivated to engage voluntarily in their treatment regimen.

Many individuals feel embarrassed or ashamed when they are unable to administer their eye drops or must disclose non-adherence to their eye care professional. Designing for patient dignity and agency can help reinforce positive experiences by acknowledging successful adherence and encouraging patients in their role of preventing further vision loss. Additionally, incorporating a home-friendly aesthetic instead of a clinical-looking device helps maintain a sense of dignity and agency as the treatment becomes part of their everyday routine.

Patient education about their condition, symptoms, treatment, emotional pain points, and the consequences of poor adherence is critical to improving treatment outcomes. Effective communication from optical health care professionals also plays an essential role in supporting adherence. For example, reminding patients that glaucoma eye drops may cause mild stinging, yet this is a normal and safe part of treatment, can reassure users and reduce anxiety. The agency of education is to prevent misunderstanding about the condition and its treatment. This includes addressing misconceptions such as the belief that glaucoma drops “cure” the disease and can be stopped once intraocular pressure improves, or the assumption that a lack of obvious symptoms means the condition is not serious. Poor adherence can result in increased eye pressure and a higher risk of progressive vision loss. When patients understand the purpose and importance of their treatment, they are more likely to remain committed to their regimen.

Supporting patients with mental barriers such as forgetfulness is also vital for adherence. These challenges can be particularly relevant for individuals with neurodivergence, dementia, age-related memory decline, depression, or anxiety, but can affect users across all demographics. Providing reminders and simplifying scheduling can help ensure that eye drops are administered correctly and consistently, contributing to better long-term outcomes and quality of life.

Physical barriers to eye drop administration commonly affect users who are unable to independently squeeze the bottle or position it at the correct angle for the drop to enter the eye. Patients with conditions such as Parkinson’s disease, tremors, arthritis, reduced upper limb mobility, limited dexterity, or decreased hand strength and grip are more likely to experience challenges in handling, aiming, and dispensing the medication, as well as recognising whether the drop has been successfully instilled. Ensuring agency in accurate drop administration helps prevent feelings of embarrassment or shame, which can reduce trust in the treatment regimen. Providing confirmation that the bottle is correctly positioned and that the drop has been delivered into the eye is essential for building confidence, maintaining trust in the process, and supporting the patient’s voluntary engagement and determination in their treatment.

Patients with Parkinson’s disease and arthritis often experience significant difficulty self-administering eye drops due to hand tremors and reduced fine motor control. This highlights the need for an ergonomic and innovative handling device that addresses both the emotional and physical aspects of usability.

The agency in designing for improved grip, handling stability, and confirmation of successful drop administration is essential to support better treatment adherence. By understanding the emotional and physical stages of the user’s journey when administering drops, design considerations such as sizing, ergonomics, aesthetics, personalisation, and material choice become critical in enhancing comfort, accuracy, and confidence throughout the process.