editor's perspective

The Economy's Effect on Compliance

BY JASON J. NICHOLS, OD, MPH, PHD, FAAO

As I write this editorial, there are signs that the economic downturn (recession) is reversing; however, we are not yet out of the dark. Analysts report that unemployment rates are very high, and these rates continue to rise regardless of other positive economic indicators. The simple fact is that all people today, including your patients, are making decisions based on the economy. This economic squeeze unfortunately can translate into altered behaviors and practices regarding their health.

More specifically, I am seeing and hearing many unfortunate stories associated with disturbing trends in our field. While we all know that these issues never really go away, some behaviors seem to be on the rise in our patients and I believe the economy is somewhat to blame. For instance, I am hearing more and more reports of patients looking to buy the cheapest "bottle" on the shelf — which just happens to be saline rather than an appropriate care solution. Several data sources show that global saline purchases have been on the rise over the past year. Likewise, patients are using their contact lenses for longer and longer periods of time. You can easily find internet blogs questioning whether daily or two-week disposable lenses can be worn for longer than what is recommended. The blog comments would be enlightening — or frightening — to any practitioner. To quote a recent thread I followed: "I have the two week ones and I tend to wear them for a month or more. I know to change them when one of them gets blurry." The blog entries about this topic go on and on.

It seems that more of our patients may be adopting unfortunate habits associated with their lens care, wear, or general compliance. As we all know very well, these habits can directly result in adverse outcomes, many of which can be quite severe including microbial keratitis. In light of this, it is even more critical that we as practitioners remain attentive in educating and re-educating our patients about proper lens wear and care. From other blog comments, it is interesting to note patient perceptions of what their doctor said was "OK." Patients may "hear" what they want to hear, and it ultimately reflects on us as practitioners and on our profession, so please be conscientious and diligent in these challenging times.