Patient-reported outcomes and acceptability during messaging-based telemedicine follow-up for dry eye disease

Telemedicine may support longitudinal management of dry eye disease (DED) through remote communication and symptom monitoring. This prospective single-group pre–post study evaluated patient-reported outcomes and acceptability during 1 month of messaging-based telemedicine follow-up delivered through LINE as an adjunct to usual ophthalmic care. Ninety-six adults with clinically diagnosed DED were included; no concurrent control group was used. Mean Ocular Surface Disease Index (OSDI) score decreased from 32.29 ± 14.41 at baseline to 22.70 ± 11.92 at 1 month, with a mean paired reduction of 9.59 points (95% CI, 7.18–12.00; p < 0.001). DEQS also decreased, with a median paired reduction of 8.54 points (IQR, 1.67–15.94; BCa bootstrap 95% CI, 4.58–10.83; Wilcoxon signed-rank p < 0.001). In exploratory multivariable analysis, baseline behavioral factors were not independently associated with OSDI change, whereas higher baseline OSDI was associated with greater subsequent reduction. Ninety participants (93.8%) would use telemedicine again, and 91 (94.8%) reported overall satisfaction. Messaging-based follow-up was highly acceptable, and patient-reported outcomes improved during follow-up; however, these improvements cannot be attributed specifically to telemedicine because usual ophthalmic care continued and no concurrent control group was included.