contact lens care and compliance

Promoting Adherence to Your Prescribed Care Regimen, Part 2

BY SUSAN J. GROMACKI, OD, MS, FAAO

In my last column, I began a list of strategies to maximize patient adherence to your prescribed contact lens care system. Here are seven more ways to keep your patients away from generics.

A Few More Steps

1. Provide patients with a sample of the solution you prescribe for them. Then instruct patients to bring the sample bottle to the store to eliminate any confusion over which product to purchase. (Unfortunately, some manufacturers have discontinued sampling certain solutions.)

2. Present to patients a copy of their solution “prescription” on an Rx pad. This reinforces the medical nature of contact lenses and their care products.

3. Show how to clean, disinfect, and store the lenses using the actual solutions and case. For some, a visual demonstration is worth a thousand words. I specifically educate patients to rub their lenses immediately after removal. Not only does this improve disinfection efficacy, but it also adds the benefit of dissuading patients from purchasing a generic solution labeled “no rub.”

Two leading formulations, Aquify (Ciba Vision) and Complete MPS Easy Rub Formula (Abbott Medical Optics) have made our job easier by removing the words “no rub” from their packaging. And, the U.S. Food and Drug Administration is revising the guidance document that specifically addresses the labeling and directions for use of all lens care products and solutions. It has also updated its consumer Web site with the recommendation to both rub and rinse contact lenses.

4. Provide handouts with good graphics. Many patients learn better via written material. For others, it will reinforce what they heard in your office. Make sure to always include the solution name. Although you do not want to forget anything important, don't overload patients with too much written information, lest it be overlooked altogether. Some practices additionally include information on a patient's prescribed solution in their mailings or newsletters.

5. Show patients an instructional video. Some practices show instructional videos utilizing the recommended care products. They may also give patients their own DVD to take home.

6. Make every follow-up appointment count. Convey in every way to patients, both before and after the visit, that this is an important utilization of their time. Do not charge a separate fee for this progress evaluation; instead, bundle the cost with the fitting/diagnostic fees, else the patient may not keep the appointment in an effort to save money.

Follow ups are of course valuable to us practitioners. I specifically look for excessive lens deposition, conjunctival hyperemia, corneal infiltrates, and corneal staining; and I listen for the symptoms of dryness, stinging, or discomfort—the latter of which is the number-one reason for contact lens dropout. In any of these cases, I am likely to change the care system or provide increased lens care instruction.

7. Review lens care at follow up. An equally important reason for the follow-up visit is to review the lens care regimen. I do this at the first follow-up appointment and at every visit thereafter. I ask patients, “Tell me how you clean your lenses from the time you start until the time you're finished.” I correct them immediately if they have developed any bad habits, and I encourage them if they're doing it right.

Many Benefits

Putting one or more of these tips into practice will not only help prevent complications that may occur with using a nonprescribed solution—it will also show your patient that you care. CLS

Dr. Gromacki is a Diplomate in the Cornea, Contact Lenses, and Refractive Technologies section of the American Academy of Optometry. She is chief research optometrist at Keller Community Hospital in West Point, New York.