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Protocol - Eye Drop Use

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Protocol Name from Source:

The Expert Review Panel has not reviewed this measure yet.

Availability:

Publicly available

Description:

A series of five questions to assess the participant's current use of drops for glaucoma, artificial tears or prescription medication for dry eyes, and steroid eye drops.

Protocol:

Administration Instructions:

Question 3: There are many manifestations of "dry eye" besides the symptoms in the question, including excess tearing. Most people will be familiar with this condition. They need not have been told by an eye doctor they have this condition. Emphasize "for the past 3 months or longer" when you ask this question. If the participant has occasional episodes of dry eye, it should on average be a complaint at least 4 out of 7 days for the past 3 months or longer. Emphasize "not related to allergy" when using the probe for this question.

Question 4: There are a number of over-the-counter artificial tears which are used for this condition. Visine, taken for allergies, does not qualify as an artificial tear unless specifically prescribed for dry eye. Drops taken for contact lens do not qualify as artificial tears for dry eye. Note that the question requires current (4 out of 7 days) use for 3 months or longer.

1. Is the participant currently taking drops for glaucoma?

[ ] 0 no

[ ] 2 yes

[ ] 8 uncertain

2. What is the name of the glaucoma drops you are using?

[ ] 2865 Alphagan®

[ ] 1152 Betagen®

[ ] 1156 Betopic

[ ] 2770 CoSopt®

[ ] 2014 Pilocar®

[ ] 2298 Timolol

[ ] 2299 Timoptic®

[ ] 2437 Xalatan®

[ ]   Other _________________

[ ] 8001 Unknown

3. For the past 3 months or longer, have you had dry eyes? (foreign body sensation with itching and burning, sandy feeling, NOT related to allergy)

[ ] 0 no

[ ] 2 OD

[ ] 3 OS

[ ] 4 OU

[ ] 5 ?eye

[ ] 8 DK

4. Do you currently use artificial tears or prescription medication for dry eyes regularly for 3 months or longer?

[ ] 0 no

[ ] 2 yes

[ ] 8 DK

5. Are you currently using steroid eye drops?

[ ] 0 no

[ ] 2 yes

[ ] 8 DK

Alphagan® and Betagen® are a registered trademarks of Allergan, Inc,; CoSopt® and Timoptic® are registered trademarks of Merck & Co., Inc.; Pilocar® is a registered trademark of Novartis Corporation; Xalatan® is a registered trademark of Pfizer Health AB.

Personnel and Training Required

The interviewer must be trained to conduct personal interviews with individuals from the general population. The interviewer must be trained and found to be competent (i.e. tested by an expert) at the completion of personal interviews*.

*There are multiple modes to administer this question (i.e., pencil and paper and computer-assisted interviews).

Equipment Needs

Either a pencil and paper or computer-assisted instrument may be used. If a computer-assisted instrument is used, computer software may be necessary to develop the instrument. The interviewer will require a laptop computer/handheld computer to administer a computer-assisted questionnaire.

Requirements

Requirement CategoryRequired
Average time of greater than 15 minutes in an unaffected individualNo
Major equipmentNo
Specialized requirements for biospecimen collectionNo
Specialized trainingNo

Mode of Administration

Self-administered

Life Stage:

Adult

Specific Instructions:

None

Research Domain Information

Release Date:

February 26, 2010

Definition

Questions to determine current and recent eye drop use

Purpose

These questions are to assess use of eye drops in general for those investigators who are interested in use of both prescription and over the counter medications. Use of specific medications may be used to augment information about the burden of specific eye conditions such as glaucoma. Also, some of the medications have systemic effects which may be of interest to an investigator.

Selection Rationale

The questions suggested have had wide use in long term studies of ocular diseases.

Language

English

Standards

StandardNameIDSource
Common Data Elements (CDE)Person Eye Drops Use Assessment3007567CDE Browser
Logical Observation Identifiers Names and Codes (LOINC)Eye drop use proto62687-9LOINC

Process and Review

The Expert Review Panel has not reviewed this measure yet.

Source

National Eye Institute, University of Wisconsin, Beaver Dam Eye Study

Beaver Dam V- 20 Year Follow-Up Interview Form

Question numbers: 55-570 [GLAU-DROPS5] (question 1), 55-572 [GLAU-NAME5] (question 2), 56-092 [DRY-EYE5] (question 3), 56-094 [DRY-EYE-RX5] (question 4), and 56-114 [STEROIDROP5] (question 5).

Last revised 2/6/09

General References

Wong TY, Knudtson MD, Klein BE, Klein R, Hubbard LD. (2005). Medication use and retinal vessel diameters. Am J Ophthalmol, 139(2):373-5.

Protocol ID:

110501

Variables:

Export Variables
Variable NameVariable IDVariable DescriptionVersiondbGaP Mapping
PX110501_Currently_Take_Glaucoma_DropsPX110501010000Is the participant currently taking drops for glaucoma?4N/A
PX110501_Glaucoma_Drops_NamePX110501020100What is the name of the glaucoma drops you are using?4N/A
PX110501_Glaucoma_Drops_Name_SpecifyPX110501020200Specify other glaucoma drops you are using.4N/A
PX110501_Dry_Eyes_Past_3_MonthsPX110501030000For the past 3 months or longer, have you had dry eyes? (foreign body sensation with itching and burning, sandy feeling, NOT related to allergy)4N/A
PX110501_Dry_Eye_Artificial_Tears_Prescription_MedicationPX110501040000Do you currently use artificial tears or prescription medication for dry eyes regularly for 3 months or longer?4N/A
PX110501_Currently_Use_Steroid_Eye_DropsPX110501050000Are you currently using steroid eye drops?4N/A