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Predictors of adherence to occlusion therapy 3 months after cataract extraction in the Infant Aphakia Treatment Study
Carolyn D Drews-Botsch1, E Eugenie Hartmann, Marianne Celano
1Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA. Cdrews@sph.emory.edu
Insights
Caregivers reported good adherence to patching for infants with unilateral congenital cataracts. Factors like private insurance and lower maternal stress improved patching success.
Area of Science:
- Ophthalmology
- Pediatric ophthalmology
- Clinical trial research
Background:
- Limited data exists on factors influencing patching adherence in infants.
- Unilateral congenital cataracts require patching to optimize visual development.
Purpose of the Study:
- To investigate predictors of patching adherence in infants treated for unilateral congenital cataracts.
- To identify factors associated with achieving high adherence rates in the Infant Aphakia Treatment Study.
Main Methods:
- Data from the Infant Aphakia Treatment Study (randomized clinical trial) was analyzed.
- Caregiver phone interviews assessed patching adherence.
- Logistic regression identified predictors of adherence.
Main Results:
- 60% of caregivers reported at least 75% adherence 3 months post-surgery.
- Adherence was not linked to treatment type (IOL vs. contact lens).
- Higher adherence correlated with private insurance and lower maternal stress.
Conclusions:
- Most caregivers achieved prescribed patching for unilateral congenital cataracts.
- Socioeconomic status and maternal stress, not correction type, influenced adherence.
- Findings highlight the importance of family support in pediatric eye treatment adherence.
Background:
Little information is available on factors that predict adherence to patching in infants. We evaluated data from the Infant Aphakia Treatment Study, a randomized clinical trial of treatment for infants with unilateral congenital cataracts, to investigate factors associated with successful adherence to patching protocols.
Methods:
In the Infant Aphakia Treatment Study, patching was prescribed 1 hour daily per month of age until 8 months of age and 50% of waking hours thereafter. A centrally located staff member inquired about the patient's adherence to patching in a phone interview with the primary caregiver. Analyses used χ(2) tests of independence and logistic regression to identify predictors of reported adherence and of achieving adherence rates of at least 75% ("good") and 90% ("excellent").
Results:
A total of 104 caregivers provided data on patching 3 months after surgery, at which time 60% reported patching at least 75% of the prescribed time. Reported adherence was not associated with the type of treatment (P = 0.73) but was better in children with private insurance (P = 0.01) and for children with mothers reporting lower levels of parenting stress (P = 0.03).
Conclusions:
Most caregivers reported being able to adhere to prescribed patching shortly after extraction of a unilateral congenital cataract. The type of correction (intraocular lens vs contact lens) was not associated with the amount of patching achieved, whereas family socioeconomic status and maternal stress appeared to play a role.
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