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Assessing interventions to increase compliance to patching treatment in children with amblyopia: a systematic review
Sarah Elizabeth Dean1, Rachel Clare Povey1, Jessica Reeves1
1School of Psychology, Sport and Exercise, Staffordshire University, Stoke-on-Trent, UK.
Insights
Educational interventions significantly improve patching compliance for children with amblyopia. This approach is more effective than altering patching schedules or using supervised occlusion for treating reduced visual acuity.
Area of Science:
- Ophthalmology
- Pediatric Vision
- Behavioral Science
Background:
- Amblyopia, or 'lazy eye,' is the leading cause of reduced visual acuity in children.
- Untreated amblyopia can lead to permanent vision loss and increased risk of blindness.
- Patching the unaffected eye is an effective amblyopia treatment but faces significant compliance challenges.
Purpose of the Study:
- To systematically review and evaluate interventions aimed at increasing patient compliance with patching treatment for childhood amblyopia.
- To determine the effectiveness of different intervention strategies in improving adherence to patching therapy.
Main Methods:
- Conducted comprehensive electronic literature searches in June 2014 and updated in April 2015.
- Included nine studies reporting primary data on interventions to enhance patching compliance.
- Employed independent data screening, extraction, and quality assessment by two researchers.
Main Results:
- Interventions incorporating an educational component demonstrated a significant increase in patching compliance.
- Educational interventions had higher quality ratings compared to those altering patching regimens or involving supervised occlusion.
- Meta-analysis of four studies confirmed a significant small effect (r=0.249, p<0.001) for educational interventions.
Conclusions:
- Educational elements are crucial for interventions designed to improve patching compliance in amblyopic children.
- Further high-quality research is necessary to identify effective components of educational interventions and complementary behavior change techniques.
Background/Aims:
Amblyopia is the most common condition affecting visual acuity in childhood. Left untreated it will not resolve itself, leading to increased risk of blindness. Occluding the good eye with a patch is a highly effective treatment if carried out before age 7 years but compliance is a major problem. This systematic review addresses the question: How effective are existing interventions at increasing compliance to patching treatment in children with amblyopia?
Methods:
Electronic searches were carried out in June 2014 and updated in April 2015 to identify studies reporting primary data on interventions to increase patching compliance. Data screening, extraction and quality ratings were performed independently by two researchers.
Results:
Nine papers were included. Interventions including an educational element (5 studies) significantly increased patching compliance and had higher quality ratings than interventions that changed aspects of the patching regime (3 studies) or involved supervised occlusion (1 study). Meta-analysis was conducted on four studies and indicated that overall interventions involving an educational element have a significant small effect r=0.249, p<0.001.
Conclusions:
Interventions to increase patching compliance should include educational elements. High quality research is needed to further assess the effectiveness of specific elements of educational interventions and additional behaviour change techniques.
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