Wireless Bottle Cap Monitor May Improve Eye Drop Adherence in Glaucoma Treatment

Wireless Bottle Cap Monitor May Improve Eye Drop Adherence in Glaucoma Treatment

June 07, 2023

According to a study published in the Journal of Glaucoma, an eye drop bottle cap monitor successfully measured and enhanced adherence among patients with glaucoma. The data revealed that 80% of users achieved a minimum adherence rate of 90% due to the intervention of the monitor.

“Glaucoma patients have high adherence when they are being monitored, and future studies with research subjects screened for poor adherence may further determine the benefit of electronic monitoring of adherence with and without electronic reminders,” Robert M. Kinast, MD, a glaucoma surgeon and associate director of the glaucoma fellowship at Legacy Devers Eye Institute in Portland, Oregon, and colleagues wrote.

Between December 2020 and May 2021, the study conducted at the Devers Eye Institute enrolled 53 participants diagnosed with glaucoma to assess the efficacy of a bottle cap monitor on eye drops in measuring and enhancing adherence.


During the initial phase of the trial, researchers utilized the Devers Drop Device (D3), a wireless smart cap monitor affixed to the bottle cap of latanoprost eye drops, to monitor nightly usage over a 25-day period. The results indicated a baseline mean adherence rate of 90%. Among the participants, 80% achieved an adherence rate exceeding 90%, while 86% achieved an adherence rate surpassing 80%. Those with adherence below 90% were eligible to continue into an additional 25-day period for further evaluation.

During the second stage of the study, the participants were randomly assigned to different groups. These groups included those who received audio, visual, or text reminders, as well as a group without any reminders. In the reminder group, if participants failed to use their eye drops at the designated dosing time, they would receive audio and visual alerts on the D3 device, along with a text message on their phone. These alerts persisted every 10 minutes for 30 minutes or until the bottle cap was removed.

Among the participants who completed the second stage of the study, notable improvements in adherence were observed. In the reminder group, two individuals demonstrated an increase in adherence by 4% (from 85% to 89%) and 46% (from 54% to 100%) respectively, when compared to their adherence during the first stage. Additionally, one participant in the no reminder group displayed an adherence improvement of 6% (from 68% to 74%).

“The D3 remained successfully attached to the eye drop bottle cap and measured adherence in all 50 subjects,” Kinast and colleagues wrote. “Adherence data was successfully stored on the D3 and usually communicated through a central server. We will need to select a higher proportion of patients with poor adherence to test whether alerts would improve adherence.”