An educational intervention to improve adherence to high-dosage patching regimen for amblyopia
Reviewed by Jonathan Chan

This is a randomised trial of patients recruited between the periods of March 2006 and March 2008 from ophthalmology clinics in the Leicestershire area. A total of 62 children with newly diagnosed amblyopia were allocated randomly into two treatment arms with and without educational / motivational intervention material. The material they used included story books for children, information booklets for parents, a quotation booklet from parents and children, a passport arriving at each hospital visit, decorated patches, charts with stickers for each patching period of three weeks, a video with information about amblyopia and a special session with an orthoptist after three weeks of patching treatment. Both the treatment arms were given patching treatment of 10-hours per day, six days per week for a fixed period of 12-weeks’ duration. The intervention arm received an educational / motivational intervention as above before patching. The control arm received the usual clinical information as routine. The primary outcome measures were the adherence measured using electronic occlusion dose and monitors where a success / failure binary outcome was used to account for participants who dropped out of the study defined as patching >4 h/day. The secondary outcome is the visual outcome expressed as a percentage of visual deficit. It was reported by the authors that the intervention arm had increased the adherence success rates from 45.2% in the controlled group to 80.6% in the intervention group (p=0.0027). There was no significant difference between the two groups for the visual outcome (p=0.19). The authors concluded that the intense educational / motivational intervention can improve adherence to patching to high prescribed doses, but without any significant improvement of the visual outcome observed in this study. They recommended a larger multicentre trial to confirm these findings.

An educational intervention to improve adherence to high-dosage patching regimen for amblyopia: a randomised controlled trial.
Pradeep A, Proudlock FA, Awan M, et al.
BRITISH JOURNAL OF OPHTHALMOLOGY
2014;98:865-70.