Development and usability evaluation of an application for patients with glaucoma.

INTRODUCTION: Glaucoma is a progressive optic neuropathy that requires continuous monitoring. The purpose of the study was to develop and evaluate the usability of a mobile application, for iOS and Android platforms, containing functionalities to improve patients' knowledge about glaucoma and facilitate their treatment. METHODS: The application was developed by a multidisciplinary team using an adapted version of a co-design methodology. Volunteers were selected, among patients and patients' relatives, from the Instituto Cearense de Oftalmologia, chosen by rational choice sampling, to answer the system usability scale after having prior orientation. The results extracted from the questionnaire were analyzed quantitatively. After grouping by age, a proportions test (z-test) was performed. RESULTS: It was possible to develop an application for mobile devices named "GlaucoCheck." Of the 36 interviewees, the average age was 51 (22-69) years old, 56% were women, and 30.5% had a university degree. The average APP score for usability in the SUS questionnaire was 75.6 (95% CI 74.1-77.2). CONCLUSION: There was an appropriate acceptance of patients to the "GlaucoCheck", as it was considered easy to handle, exhibiting interactive and uncomplicated layout. It was possible to develop an application and to register a positive acceptance by the users, encompassing functions that permits better adherence to treatments and additional knowledge about glaucoma.

A Novel Mobile Application for Preoperative and Intraoperative Assessments of Intrastromal Corneal Ring Segments Implantation for Keratoconus.

PURPOSE: To develop a mobile app that allows photographs to be captured and edited under the overlay of images and projection of a protractor with 360 degrees axis markings, which enables the surgeon to accurately visualize the programmed and marked alignment where the intrastromal corneal ring segments (ICRS) will be implanted, detecting possible marking errors. METHODS: A codesign methodology was chosen to develop the Eye Axis Check application. After app development, measurements were obtained, and comparisons were made between manual marks and ICRS alignment with and without the app in 13 eyes that had undergone ICRS implantation for keratoconus. The mobile app was made available to 15 ophthalmic surgeons in different cities to assess its usability. RESULTS: The users approved the developed application for ease of use and utility. No difference was found between the markings made manually and those made with the app, and the mean difference between ICRS centralization and assessment made by the app was 4.84 degrees (95% confidence interval: -5.32 to 15.01; P = 0.3193). On comparison of the agreement between app measurements and manual measurements for the ICRS centration, no significant differences were found, and excellent concordance (0.991) and a strong positive linear correlation (0.984) were observed. CONCLUSIONS: A mobile app for preoperative planning and intraoperative ICRS alignment was developed and revealed to be useful and easy to use, allowing the surgeon to visualize the programmed alignment where the ICRS will be implanted.

Pharmacoepidemiology of the antiglaucoma drugs in Brazil from 2012 to 2018 / Farmacoepidemiologia das drogas antiglaucomatosas no Brasil de 2012 a 2018

Abstract Purpose: To outline the epidemiological profile of clinical treatments for glaucoma provided by the Brazilian Unified Health System (SUS, acronym in Portuguese) between January 2012 and December 2018. Methods: A quantitative and descriptive study was conducted using available data based on the outpatient information system from SUS (SIA/SUS, acronym in Portuguese). The variables were monocular treatment with first, second, and third-line drugs; monocular treatment with combinations of two drugs and three drugs from different lines; binocular treatment with first, second, and third-line drugs; and binocular treatment with combinations of two drugs and three drugs from different lines. Results: During the analysis period, the prevalence of clinical therapies for glaucoma increased from 2012 to 2017 and decreased from 2017 to 2018. Of the clinically treated patients, 96% were carriers of binocular glaucoma. Among the regions of Brazil, the Northeast had the highest prevalence of binocular glaucoma (about 60% of the number of cases), and the most common therapy was combinations of two drugs from different lines. The Southeast region had the highest concentration of monocular glaucoma (53% of cases), and the predominant therapy was combinations of three drugs from different lines. The Midwest region had the lowest prevalence of monocular-treatments for glaucoma (less than 6%). Conclusion: In Brazil, the highest number of treatments offered by the public health system was in the Northeast and Southeast regions. There is a high national prevalence and potential for the morbidity of this disease. Therefore, it is necessary to strengthen programs aimed at early diagnosis and appropriate treatment to reduce adverse outcomes.

Resumo Objetivo: Traçar o perfil epidemiológico do tratamento clínico para o glaucoma no Brasil fornecido pelo Sistema Único de Saúde (SUS), no período de janeiro de 2012 a dezembro de 2018. Métodos: Estudo quantitativo e descritivo, utilizando a base de dados disponível no Sistema de Informações Ambulatoriais do SUS (SIA/SUS). As variáveis utilizadas foram: tratamento monocular com drogas de primeira, de segunda e de terceira linha; tratamento monocular com combinações de duas drogas e de três drogas de diferentes linhas; tratamento binocular com drogas de primeira, de segunda e de terceira linha; e tratamento binocular com combinações de duas drogas e de três drogas de diferentes linhas. Resultados: Durante o período analisado, a prevalência de terapias clínicas para o glaucoma aumentou entre 2012 e 2017 e diminuiu entre 2017 e 2018. Dos pacientes tratados clinicamente, 96% eram portadores de glaucoma binocular. Entre as regiões do Brasil, o Nordeste teve a maior prevalência de glaucoma binocular (cerca de 60% do número de casos), e a terapia mais comum foi a combinação de duas drogas de diferentes linhas. A região Sudeste teve a maior concentração de glaucoma monocular (53% dos casos), e a terapia predominante foi a combinação de três drogas de diferentes linhas. A região Centro-Oeste apresentou a menor prevalência de tratamentos monoculares para o glaucoma (menos de 6%). Conclusão: No Brasil, o maior número de tratamentos oferecidos pelo sistema público de saúde foi nas regiões Nordeste e Sudeste. Existe uma alta prevalência nacional e um alto potencial para morbidade desta doença. Portanto, é necessário fortalecer programas voltados para o diagnóstico precoce e para o tratamento adequado a fim de reduzir os resultados adversos.