Patients Weigh In On a Multipurpose Solution

A survey for one multipurpose lens solution shows that patients do not think that all solutions are equal.

Patients Weigh In On a Multipurpose Solution
A survey for one multipurpose lens solution shows that patients do not think that all solutions are equal.
By Lynn A. Lasswell, OD, FAAO

Have you ever wondered if the type of contact lens solution you give to patients makes a difference to them? A simple but broad survey from Advanced Medical Optics (AMO), makers of Complete Multi-Purpose Solution, concluded that for many patients it does.

Although eyecare practitioners may think that all multipurpose solutions (MPSs) are the same, AMO says its survey indicates that patients do have preferences. The company's survey illustrates how marketing tools can both reach potential customers and also strengthen patient/practitioner relations -- all while collecting valuable information for a company. In turn, the data can provide site-specific feedback for eyecare providers whose patients participate.

Complete Multi-Purpose Solution is thicker than other MPSs and it's the only such solution that contains an ophthalmic lubricant, hydroxypropyl methyl-cellulose (HPMC hypromellose). The US Food and Drug Administration has categorized HPMC as a demulcent, an agent applied topically to the eye that increases viscosity, protects and lubricates ocular surfaces and relieves dryness and irritation. It's a main ingredient in several leading tear products that eyecare practitioners recommend to treat dry eye disease. During contact lens wear, HPMC is time-released into the tear film.

Complete's primary competition in the US market is from Opti-Free Express (Alcon) and ReNu MultiPlus (Bausch & Lomb).

Designing the Survey

The AMO survey combined an approach that is a marketing legend -- the "Pepsi Challenge" -- with a simple, mail-in questionnaire for patients. AMO distributed the questionnaire inside Complete patient starter kits, which practitioners began distributing in the third quarter of 2002.

The company gave the kits to approximately 1,000 clinicians, most of whom typically recommended competing MPS brands. AMO asked the practitioners to give the kits to at least 100 of their existing patients who were using competitive MPSs.

Practitioners distributed more than 500,000 kits, and patients returned about four percent of the questionnaires during a nine-month period from October 2002 through June 2003. AMO was pleased with this response rate because three percent is typically considered a good response for a mail questionnaire, according to the company. The marketing team at AMO believes that part of the reason for the high response rate was the questionnaire's simplicity. AMO structured the questionnaire in much the same way it structures patient monitoring tools in the company's clinical trials.

The questionnaire asked contact lens wearers to use the two-ounce sample bottle of Complete Multi-Purpose Solution for seven to 10 days, then rate its performance compared to their previous contact lens solution on a scale that ranged from "Much better" to "Much worse." The five questions addressed lens comfort on initial insertion; eye comfort throughout the day; prevention of dryness and irritation; effectiveness at cleaning lenses and keeping vision clear; and overall performance.

The Survey Says...

The 20,731 responses were overwhelmingly positive about AMO's MPS. For all five questions, 78 percent or more of the patients rated Complete Multi-Purpose Solution better than the brand they had been using. Eighty-two percent of respondents rated Complete's overall performance better (Table 1).


Survey Responses

1. Lens comfort upon initial insertion 78%
2. Lens comfort throughout the day 78%
3. Shields lenses from dryness and irritation 78%
4. Cleans lenses and keeps vision clear 78%
5. Overall performance 83%


Even though these numbers seem high, in their raw form they wouldn't meet a statistician's criteria for a scientifically verifiable result. The reason is that patient selection was not randomized because eyecare practitioners selected respondents to switch to Complete Multi-Purpose Solution only if they were using competitive brands.

Still, it's hard to dismiss the enthusiasm that some respondents displayed on the questionnaires:

  • "The difference on initial insertion was amazing."
  • "I don't need to use artificial tears with Complete Multi-Purpose Solution."
  • "My contact lenses always bothered me and dried out before I tried Complete."
  • "Didn't know solutions could feel different."
  • "The solution is thicker...adding moisture needed for comfort all day long."
  • "Longer comfortable wear...A+ + +."
  • "It doesn't feel like I'm wearing lenses."
  • "I'm not going to have LASIK because now that I've switched to Complete, it feels like I don't even have lenses in my eyes."
  • "Love this solution. Why have I never heard of it?"
  • "This office always stays on top of new products."

Practitioners Offer Feedback

Once the results were in, AMO closed the survey loop by collating the results by individual practitioner and giving them to the company's sales representatives to share with the practitioners. Thus, in a way that usually isn't possible for a mass-market tool, the AMO reps could say to the practitioners, "This is what your patients think about Complete Multi-Purpose Solution."

Mark Stephenson, OD, of Freehold, NJ, said that even before he saw the survey cards he knew his patients were positive about switching to Complete Multi-Purpose Solution. "My patients reacted positively. Most indicated that Complete seemed to clean their lenses better and increased comfort," Dr. Stephenson said.

Kirk L. Smick, OD, of Atlanta said all of his patients who switched to Complete MPS thought it was comparable to or better than the solution they had been using.

"If anything, the survey showed me on a slightly more formal basis that it's hard to get in trouble using Complete with my patients," Dr. Smick said. "I had a feeling that would be the case, but I didn't know for sure."

For New Jersey optometrist Stanley F. Anton, the survey results have functioned as a practice builder in a difficult time. This summer Dr. Anton completed his first year in a new practice located about 20 miles from New York City -- a move he made because his former practice site was in the World Trade Center.

"Our World Trade site was the best practice location in the world, and at this location we've had a slow start," Dr. Anton said. "Several months ago an AMO sales rep visited and suggested that I switch some of my patients to Complete Multi-Purpose Solution. I had switched to Opti-Free several years back, but she made a good presentation so I told her I'd give it a try."

The feedback from patients was so positive that Dr. Anton has since switched all of his patients to Complete Multi-Purpose Solution. He also recommends AMO's Blink­N-Clean in-eye cleaning drops.

"Many of my patients have used different products that I didn't like, as well as generics, or they've mixed and matched lens care solutions and were experiencing a lot of irritation," Dr. Anton said. "I haven't received one negative report since switching them. I've had 100 percent acceptance. I almost view it as a practice builder, because I won them over with a product that they have come to appreciate as being better for them."

Choosing a Winner

While the results of a patient questionnaire survey generally cannot compare to those from a well controlled scientific clinical study, the responses in this survey indicate that patients who switched from their previous care regimen to Complete Multi-Purpose Solution expressed quite a favorable opinion of the product. Whether it was with respect to overall comfort, duration of comfort, a feeling of greater moisture in their lenses or prolonged lens wearing times, patients generally felt that Complete offered definite advantages over their previous multipurpose solution. Complete proved to be a clear winner in the minds of the large majority of respondents in this survey.

Dr. Lasswell is the manager of clinical research for eye care (contact lens) and refractive surgery products at Advanced Medical Optics (AMO). He has published several papers and articles related to contact lenses and refractive surgery.