Your Role in Your Patients' Compliance
BY JASON J. NICHOLS, OD, MPH, PHD, FAAO
I value historical aspects of our profession and feel quite strongly that we need to understand why we are where we are so we can gain insight to move forward—this perspective is invaluable. Ask any one of my optometry students. I start each quarter by teaching them the history of contact lens materials because I feel it is important that they generally understand, for example, how and when the field moved from PMMA to silicone acrylate GPs to fluorosilicone acrylate GPs. Likewise, I think it helps students and practitioners to generally understand how and when hydrogels were developed, and how the chemistry of the first soft lens materials was closely related to PMMA.
Where am I going with all of this?
You probably have noticed a recent increase in discussion about compliance. We at Contact Lens Spectrum have certainly been involved in those discussions by bringing you various research topics and individual perspectives on compliance and related issues. Among all of the recent discussion, you will hear that patients are more compliant with a certain modality, certain care regimen, and certain hygiene habits. However, in the midst of all of this discussion, I have been left wondering whether anything has really changed. In the August 2005 issue (five years ago), emeritus editor Dr. Joe Barr wrote his Editor's Perspective on “Motives for Compliance.” In the editorial, he described himself as noncompliant with his care regimen. He discussed the individual issues that might have led to his noncompliant behaviors. The one thing that I found lacking was the involvement of his eyecare practitioner!
All joking aside, among all of the data on compliance and individual perspectives and opinions that you will hear, the opinion that I would like to emphasize most to you is your role as a practitioner in the process. Will some patients perpetually continue noncompliant behaviors? Certainly, even after they experience a significant inflammatory or infectious event. This does not mean that we are not professionally, ethically, and legally bound to continue due diligence in educating our patients about the importance of following instructions for lens wear and care. After all, they entrusted you with their eye health in the first place, so please keep this in perspective the next time you have contact lens patients in your chair.