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Strategies to Better Engage, Educate, and Empower Patient Compliance and Safe Lens Wear: Compliance: What We Know, What We Do Not Know, and What We Need to Know

Donshik, Peter C. M.D.; Ehlers, William H. M.D.; Anderson, Lynn D. Ph.D.; Suchecki, Jeanine K. M.D.

doi: 10.1097/ICL.0b013e318157f62a

Purpose. To assess the extent of noncompliant behavior of contact lens wearers and to develop strategies of engaging and educating patients to increase compliance with safe contact lens practices.

Methods. The literature regarding noncompliance with medical regimens, contact lens wear, and cleaning was reviewed. One hundred eleven contact lens wearers from a college campus, a dental clinic, and ophthalmology clinics were surveyed in a pilot study regarding their contact lens knowledge, attitudes, and practices. Statistical analysis of the results was performed with SPSS software.

Results. A review of the literature found overall rates of noncompliance with medical regimens varies from 24.8% to 44%, and the rates reported for contact lens wearers varies from 50% to 99%. Noncompliant behavior affecting the safety of contact lenses is more common than behavior affecting lens comfort. This study found that many lens wearers thought they were compliant, but actually reported a wide variety of noncompliant behaviors.

Conclusions. Although there have been remarkable advances in contact lens science, noncompliance with lens-wearing schedules, replacement schedules, and lens care regimens remains a significant problem of contact lens complications and lens failure. Noncompliant behavior is a complex phenomenon that involves knowledge, attitudes and beliefs, and available resources. Data regarding strategies for increasing compliance are scant. Noncompliance must be considered in the development of future lens care products and must be addressed by eye care professionals when patients are fitted with contact lenses and at each follow-up appointment.

From the University of Connecticut Health Center (P.C.D., W.H.E., J.K.S.), Farmington, CT; and the Joint Commission on Allied Health Personnel in Ophthalmology (L.D.A.), Saint Paul, MN.

Address correspondence and reprint requests to Dr. P.C. Donshik, 47 Jolly Drive, Bloomfield, CT 06002; e-mail:

Accepted August 1, 2007.

© 2007 Lippincott Williams & Wilkins, Inc.