Authors: Rookaya Mather, Evan Michaelov, Manav Nayeni, Arpit Dang
Author Disclosure Block: R. Mather: None. E. Michaelov: None. M. Nayeni: None. A. Dang: None.

Abstract Body:

Purpose: To determine the factors that influence adherence to dry eye therapy and identify burdens experienced by patients with Sjogren’s disease with respect to ocular symptoms, financial impact of treatment, and disease-related anxieties.
Study Design: Prospective Cohort Study.
Methods: A 27-questions survey was created with both online and paper versions, and was distributed to members of the Canadian Sjogren’s Society and patients of a cornea specialist in London, Ontario (RM). All responses were anonymous, and were analyzed using SPSS software (IBM, Armonk, NY).
Results: 244 patients with Sjogren’s disease were enrolled from March to August 2018. The majority of patients (171, 70.1%) were diagnosed by a rheumatologist. Median age of respondents was 61 (IQR 53-68). 31.8% of respondents had a household income of <$40 000 CAD. Private insurance was held by 35.7% of respondents, however only 2.9% had coverage of non-prescription agents for their dry eye disease.
Dry eye symptoms experience by patients included ocular irritation (76.6%), burning sensation (56.1%) and foreign body sensation (54.4%). Patient’s feared reduced quality of life (76.6%) and blindness (52.9%) due to their dry eye disease. The most common reported reason for missed dry eye treatments were cost of therapy (36.1%) and forgetfulness (32.4%). A majority of patients (83.1%) reported using some form of drop rationing technique to reduce cost of therapy, including using single use vials of medication more than once (41.8%), using fewer drops than prescribed (30.3%) and using drops past expiry (22.5%). However, 24.7% of patients claimed they would not reveal to their physicians that they were not using their medications as advised.
Conclusions: Dry eye disease poses a substantial burden, both financially and in terms of quality of life for patients suffering from Sjogren’s disease. High drop burden promotes sub-therapeutic and potentially unsafe medication rationing techniques. Eye care professionals need to be aware of the factors that influence patient adherence to dry eye therapy, as well as understand the impact of dry eye symptoms, socioeconomic status, and mental outlook on the overall patient experience of patients with Sjogren’s disease.