Improving patient education and attitudes toward compliance with instructions for contact lens use

Aims: To examine reasons for non-compliance with recommended methods of successful contact lens wear and care, and to use that analysis to improve instruction as well as to apply the principles of social influence and other methods of behaviour modification to improve patient understanding of and attitudes toward compliance. Methods: A review of studies of non-compliance and an analysis of educational methods, content and sequencing. Results: The high prevalence of intentional and unintentional non-compliance confirms the need for improved methods of education and attitudes toward compliance. Education may be unsuccessful because of auditory processing disorders and reading disability syndromes. Methods which appear likely to contribute to improved compliance include: keeping records of the progress made through a comprehensive syllabus, commencing education at the prescribing visit, postponing non-urgent components to aftercare visits, compensating for patient shortcomings in the areas of understanding verbal instructions and reading support literature, and improving frequency and impact of communications with patients. Conclusions: In addition to improved instruction, there is an indication for using behaviour modification techniques, such as the principles of social influence, to achieve changes in patient attitudes toward compliance. For example, patient attitudes toward compliance may be improved by understanding why so many people continue to wear and benefit from the many advantages of contact lens corrections, as well as appreciating how too many patients become contact lens failures due to non-compliance. There is a strong indication for progressive monitoring of compliance but the methods used should avoid confrontation with and any offence to patients. (C) 2011 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.