New Glaucoma Research: Will Patients and Family Members Pay for a Glaucoma-Specific App? Not Likely, Results Say

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New – and highly relevant – research from the Wills Eye Glaucoma Research Center, in collaboration with Drexel University, sought to “evaluate the interest of glaucoma patients and their caregivers in a smartphone-based and tablet-based glaucoma application” (app) that contained a range of features (explained below) designed to (a) increase patients’ level of knowledge about glaucoma and (b) improve their adherence to medication and follow-up appointment recommendations.

Their research results, which are applicable to doctors, patients, family members, rehabilitation professionals, and app developers, indicate that participants were more likely to download the App if it was free of charge, compared with a version that cost $3.00.

From the Journal of Glaucoma

This new glaucoma app research, titled The Wills Eye Glaucoma App: Interest of Patients and Their Caregivers in a Smartphone-based and Tablet-based Glaucoma Application has been published in the Journal of Glaucoma, the official journal of the American Glaucoma Society. The purpose of the Journal is to provide “a stimulating forum for discussion of clinical, scientific, and socioeconomic issues of greatest concern to clinicians who care for glaucoma patients.”

The authors are Michael Waisbourd, MD; Hermandeep Dhami, BSc; Chen Zhou, BSc; Michael Hsieh, BSc; Pramod Abichandani, PhD; Michael J. Pro, MD; Marlene R. Moster, MD; L. Jay Katz, MD; Lisa A. Hark, PhD, RD; and Jonathan S. Myers, MD, from the Glaucoma Research Center, Wills Eye Hospital, and the Drexel University iSchool and College of Engineering, Philadelphia, PA.

About the Wills Eye Hospital Glaucoma App Research

Excerpted from Wills Eye Hospital study details why they built a glaucoma app and patient price sensitivity to medical apps, via iMedicalApps:

Wills Eye Hospital has a [new] glaucoma app for patients called Glaucoma from Wills Eye. They built their glaucoma app over a two-year period, in conjunction with Drexel University’s iSchool and College of Engineering. Before releasing the glaucoma app, they did an internal study to see what key features patients would want.

Fifty participants were in the study and they were asked questions on key features they would want in the app. Some key findings from the study were the respondents’ answers when it came to mobile technology. Almost 70 percent of patients already had a smartphone or tablet. Nearly half the patients used their smartphones at some point to look up health information.

Out of all the conclusions, the price sensitivity for downloading a health app was the most interesting. While more than 70% of the patients were interested in downloading the Wills Eye Glaucoma app, only 25% of the patients would actually download the app if it was priced at just $3.00. I call this the “Angry Birds” effect. The gaming section is filled with apps that are free or just $0.99. They can afford to do this since there are a significant number of individuals available to download these apps.

For medical specialty apps to succeed financially (be able to at least pay for development costs), they need to charge [a much higher price], since the number of individuals that have the potential to actually use the app is significantly smaller. Unfortunately — even though patients find these types of medical apps useful — the barrier of price, which is similar to a cup of coffee at Starbucks, prevents this from happening.

What Is Glaucoma?

Glaucoma is a group of eye diseases that can lead to blindness by damaging the optic nerve, which transmits information from the eye to the brain, where it is processed and interpreted. The eye continuously produces a fluid, called the aqueous, that must drain from the eye to maintain healthy eye pressure. Glaucoma is particularly dangerous to your vision because there are usually no noticeable initial symptoms or early warning signs.

The Different Types of Glaucoma

Primary Open Angle Glaucoma

The most common type of glaucoma is Primary Open Angle Glaucoma (POAG). In POAG, the eye’s drainage canals become blocked, and the fluid accumulation causes pressure to build within the eye. This pressure can cause damage to the optic nerve, which transmits information from the eye to the brain.

Vision loss is with this type of glaucoma is usually gradual, and often there are no early warning signs. There is a strong genetic predisposition for this type of glaucoma.

Angle Closure Glaucoma

Angle Closure Glaucoma is much less common than POAG in the United States. In this type of glaucoma, the aqueous cannot drain properly because the entrance to the drainage canal is either too narrow or is closed completely. In this case, eye pressure can rise very quickly and can be triggered by pupil dilation.

Symptoms can include sudden eye pain, nausea, headaches, and blurred vision. If you experience these symptoms, you should seek immediate medical treatment.

Normal Tension Glaucoma

In this type of glaucoma, also called low-pressure glaucoma, there is damage to the optic nerve, even though the eye pressure is not elevated excessively. A family history of any type of glaucoma, cardiovascular disease, and Japanese ancestry are a few of the risk factors for this type of glaucoma.

This type of glaucoma is treated much like POAG, but the eye pressure needs to be kept even lower to prevent progression of vision loss.

Secondary Glaucomas

Secondary glaucomas are those that develop as secondary to, or as complications of, other conditions, including eye trauma, cataracts, diabetes, eye surgery, or tumors.

Series of four photos demonstrating typical progression of vision loss due to glaucoma. Source: National Eye Institute

The typical progression of vision loss from glaucoma
Source: National Eye Institute

Detecting Glaucoma

National Glaucoma Awareness Month provides an excellent opportunity to learn more about glaucoma, a leading cause of vision loss that affects more than 3 million people in the United States. Glaucoma often is called “the sneak thief of sight” for good reason: Many people are unaware that glaucoma has few symptoms or warning signs in its early stages. Early treatment for glaucoma can usually (but not always) slow the progression of the disease. However, as of yet, there is no cure for glaucoma.

Because glaucoma has no obvious initial symptoms, a comprehensive dilated eye exam is critical to detect early glaucoma changes. People who are over 40 should have a dilated eye examination from an ophthalmologist or optometrist at least every two years. African Americans; people who are over 35 and have a family history of glaucoma; and everyone age 60 or older should schedule a comprehensive eye examination every year.

You can learn more about glaucoma detection and treatment at How Can I Detect Glaucoma if There Are No Initial Symptoms?, What Are the Different Treatments for Glaucoma?, and Tips for Taking Glaucoma (and Other) Eye Drops at VisionAware.

More about the Wills Eye Hospital Glaucoma App

screen shot of the Wills Eye glaucoma app
Screen shot of the app

Excerpted (with screen shot) from the free Wills Eye Hospital Glaucoma App, available at the iTunes Store:

The free Wills Eye Hospital Glaucoma App was designed to educate patients and their caregivers about glaucoma and help them manage their eye disease by using an automated eye-drop reminder feature and a calendar for tracking eye exam appointments. The main features of the App include:

  • Educational videos about glaucoma, how to use eye drops, benefits of glaucoma laser treatment, and surgery
  • Tutorial on how to take a visual field examination
  • Eye-drop reminder feature
  • Appointment reminder feature
  • Storage of medical information
  • Tracking of eye pressure results

Compatibility: Requires iOS 8.0 or later. Compatible with iPhone, iPad, and iPod touch.

More about the Study from the Journal of Glaucoma

Excerpted from the study abstract:

Purpose: To evaluate the interest of glaucoma patients and their caregivers in a smartphone-based and tablet-based glaucoma application (App), developed by the Wills Eye Glaucoma Research Center in collaboration with Drexel University.

Materials and Methods: Cross-sectional survey of patients with glaucoma and their caregivers. Main outcome measures are answers to survey questions regarding how receptive participants are to using the Glaucoma App.

Results: Fifty subjects completed the survey. The mean age was 59.5 years. A total of 88.6% of the participants lived in a household with access to a smartphone or tablet. The majority (72.3%) of participants would consider downloading the Glaucoma App, and younger participants (less than 65 years) were more likely to do so compared with their older (more than, or equal to, 65 years) counterparts.

Participants were more likely to download the App if it was free of charge, compared with a version that costs $3. Although only about one third (37.8%) of participants used eye drop reminders, nearly 3 of 4 (72.9%) participants were receptive to using the automated reminder feature of the Glaucoma App.

Conclusions: Glaucoma patients and their caregivers were very interested in using a Glaucoma App; however, many were not willing to spend $3 for an App they seem to value. The free Wills Eye Glaucoma App currently available on the Apple store, includes educational videos, eye drop and appointment reminders, medical and ocular data storage, visual field tutorial, and intraocular pressure tracker. These features aim to increase patients’ level of knowledge about glaucoma and improve their adherence to medication and follow-up appointment recommendations.

More Helpful (and Free) Apps from American Foundation for the Blind (AFB) and VisionAware

Additional Glaucoma Information