A systematic review of improper eye drop application and role of pharmacists for patient education

The application of eye drop is encountered with many technique errors, which can lead to decreased therapeutic response and treatment failure. Community pharmacists can play a pivotal role in providing appropriate knowledge and counselling services for the proper and effective use of eye drop. The aim of this systematic review was to assess the most important aspects of technique errors regarding eye drop application, along with the important role and impact of community pharmacist-led interventions towards the provision of patient education and counselling regarding the proper application of this topical preparation in clinical practice. PRISMA criteria were used to conduct a systematic search on the administration of eye drop through different databases, including Scopus, Web of Science, and PubMed between the years 1990 and 2023. A total of 22 articles were included in this study. Nearly three-quarters of the studies discussed the improper technique and non-adherence for eye drop instillation (77.3%). Five studies discussed the interventions by health care professionals for proper eye drop instillation technique (22.7%). Two studies discussed the intervention by community pharmacist in patient education and improved training on the correct instillation of eye drop. There are different aspects of application errors encountered by patients while using eye drop, particularly in glaucoma elderly patients, and polypharmacy. These application errors could lead to a diverse range of complications, such as poor medication, ocular infections, increased health care expenses, reduced treatment effectiveness, and lower health outcomes. There is a potential role of pharmacist-led interventions in minimising procedures associated with improper technique and application of eye drops to avoid decreased therapeutic response and treatment failure.