contact lens care and compliance

Promoting Adherence to Your Prescribed Care Regimen, Part 1

BY SUSAN J. GROMACKI, OD, MS, FAAO

Arecent study by Forister et al (2009) found a statistically higher rate of contact lens complications in patients who use private-label solutions. Although the percentage of generic solutions purchased currently stands at 25 percent, we have the power to lower that number. A patient's behavior is profoundly influenced by what he sees, hears, and learns from his practice of choice. Here are some actions you and your staff can take to promote optimal adherence to your prescribed lens care regimen.

Steps to Promote Adherence

1. Communicate your choice of contact lens solution from the examination room. One sequelae of the Fusarium and Acanthamoeba keratitis outbreaks has been the shifted responsibility of care system selection from ancillary staff member to practitioner. Practitioners are now carefully prescribing solutions based on good clinical reasons.

I specifically select a care solution myself and briefly outline the care regimen with the patient. I then read with each patient the care instructions printed on the solution's box or insert and request that he review them at home. I write the product name in the patient's chart and send him to my technician for application and removal training; she will then provide a more thorough instruction regarding the lens care regimen.

2. Properly educate both patients and staff. Set aside a dedicated area (quiet, pleasant, and well-lit) for contact lens training. Select a specific staff member or two to provide this education. Choose someone who will demonstrate patience and dedicate ample time to each patient.

Figure 1. Patients encounter a myriad of contact lens care systems on the retail shelf. It is up to you to steer them in the right direction.

Furthermore, make sure that you and your staff members are on the same page. Your technicians must share your philosophy on proper contact lens care and follow up so that patients will receive a consistent message no matter whom they're interacting with in the practice.

3. Explain that the care system you have chosen is unique — and that not all solutions are alike. Generic brands are often older formulations of the name brands. In fact, many of the current generic solutions predate the new silicone hydrogel materials. The end result could be increased sensitivity reactions, corneal staining, or decreased comfort. Patients may be overwhelmed by the vast number of solutions on the retail shelves or think that they're all the same and shop for the best price (Figure 1). I instruct patients not to deviate from my chosen brand because I selected it specifically to work in combination with their lens material, wearing and replacement schedule, and eye health. Lastly, I emphasize using fresh disinfection solution every time (no "topping off), cleaning the contact lens case daily, and replacing it every three months.

Better Education Encourages Better Compliance

In summary, the better you and your staff educate a patient regarding proper compliance, the more likely it is that he will stick to your prescribed regimen. CLS

For references, please visit www.clspectrum.com/references.asp and click on document #169.

Dr. Gromacki is a Diplomate in the Cornea and Contact Lens section of the American Academy of Optometry. She lives in West Point, New York.