Longitudinal health-related quality of life among self-selected users of a mobile medication reminder application in glaucoma: a single-center prospective observational cohort study

Background Patient-reported quality of life during routine use of mobile medication-support applications in glaucoma is poorly characterized. Objective To characterize longitudinal health-related quality of life among self-selected OcuDrop users and explore associated factors. Methods This single-center prospective observational cohort included adults with glaucoma or ocular hypertension recruited through a clinic announcement that specified Android-only availability. Participants voluntarily used the medication-reminder application during routine care. EQ-5D-5L was assessed at baseline and months 1, 2, and 3; NEI-VFQ-25 was exploratory. Random-intercept mixed models evaluated change over time. App events were linked using pseudonymous identifiers. Results Of 81 voluntary app users, 64 enrolled and 54 had EQ-5D-5L data at all visits. Mean utility was 0.681 at baseline, 0.730 at month 1, 0.777 at month 2, and 0.775 at month 3 (overall P = 0.001). The month-3 within-person change was 0.094 (95% CI: 0.030 to 0.159; Cohen dz = 0.40); clinical importance could not be determined because no applicable glaucoma-specific Thai minimal clinically important difference was identified. Older age was associated with lower baseline utility, and baseline utility with month-3 utility, in exploratory models. Among 54 participants, 50 generated at least one app event and 39 generated an event in month 3. Ten enrolled participants had no available EQ-5D-5L records data and used more topical medications than included participants. Conclusion EQ-5D-5L utility increased over three months among self-selected users, but the uncontrolled design, Android-only eligibility, missing outcomes, and variable engagement preclude attribution to OcuDrop. Findings are hypothesis-generating.