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Biomedical subjects

B E Claydon

Publications and source records attributed to B E Claydon.

4 recordsLinked to original sources

Non-compliance in optometric practice.

The purposes of this paper is to explore how some of the recent and future changes relating to the optometric profession could affect non-compliant behaviour among patients. Non-compliance has been widely documented and discussed in numerous health care fields and is understood to be the responsibility of both the practitioner and patient working in a health care partnership. At least one third of patients have been reported to be non-compliant with health care recommendations which can result in the poor outcome of a treatment, secondary medical problems, dissatisfaction, frustration and the wasting of health resources. In recent years contact lens complications have been linked with non-compliant behaviour with contact lens care and maintenance regimens which has led to several media scares over contact lens related hygiene risks and has heightened interest in the issue of non-compliance in the field of optometry. Shared care schemes have already been adopted in some areas of the United Kingdom and if therapeutic pharmaceutical agents are introduced to the list of drugs permitted for use by optometrists in the future the issue of non-compliance will become even more poignant. Every optometrist needs to be aware of the high probability of non-compliant behaviour among patients, the consequences of this non-compliance and the steps that can be taken to enhance compliance in different areas of eye-care.

Contact Lenses↗

A prospective study of the effect of education on non-compliant behaviour in contact lens wear.

The contact lens practitioner and patient present a specific case for the study of non-compliance in areas such as hygiene, solution use, appointment attendance and wearing times. Education is one of the factors thought to influence compliance among patients in general health care situations and contact lens practitioners are encouraged to educate patients in the care and maintenance of contact lenses. A prospective, randomized, controlled and double masked study was performed to assess the effect of a 'compliance enhancement strategy' on levels of compliance among contact lens wearers over twelve months. Eighty experienced contact lens patients were randomly allocated to two experimental groups. A standard level of contact lens instruction was applied to the first group and in addition the compliance enhancement strategy was applied to patients assigned to the second group. The strategy consisted of extra education for patients using a video, booklets, posters, a checklist and a health care contract. Patients were given free supplies of ReNu multipurpose solution and Medalist 38 soft contact lenses (Bausch and Lomb, Rochester, New York). Compliance levels were assessed at a twelve month aftercare appointment by demonstration and questionnaire. The results indicate that the compliance enhancement strategy had little significant effect on the compliance levels of the patients to who it was applied. The population of contact lens wearers were generally very compliant and the contact lenses and care regimen were clinically successful. The possibility that the assessment of non-compliance was not adequately sensitive to highlight small differences in non-compliant behaviour is discussed. The standard level of education applied to this sample of contact lens patient were adequate to ensure generally high levels of compliance with the simple care and maintenance regimen recommended.

Adolescent↗

Non-compliance in general health care.

An increased interest in non-compliance has been demonstrated by the great number of papers recently published on the subject. A review of the relevant literature shows a pattern emerging of at least one third of clients being non-compliant. This can result in a hazard to health, a waste of health resources and much frustration for practitioners and clients in many areas of health care. There are multiple factors which appear to be related to non-compliance in a complex and interdependent way. These factors can be described under three main headings: the client, the treatment and disorder, and the clinic interactions. Compliance is summarized as the shared responsibility of practitioner and client in a health care partnership. The purpose of this paper is to review the extensive literature on compliance in general health care and to present a set of guidelines for the enhancement of compliance in the form of a general model.

Attitude to Health↗

Non-compliance in contact lens wear.

Non-compliance is emerging as a critical issue in the contact lens field. This problem has been studied at depth in general health care situations and is seen as the responsibility of both practitioner and patient (client) working in a health care partnership. The contact lens practitioner and patient present a specific case for the study of non-compliance in areas such as hygiene, solution use, appointment attendance and wearing times. From 40 to 91% of contact lens patients have been reported as non-complaint in the use of recommended care and maintenance regimens and many of these are confused or ignorant about their behaviour. In order to arrive at a general set of conclusions from the studies published to date, it is important to understand the methodology of each study, it purpose, the definition of non-compliance used and the way the results were analysed and described. This review summarizes the research into non-compliance in the contact lens field to data. A set of general conclusions is drawn and a model for compliance in the context of contact lens practice is proposed.

Age Factors↗