By Jason R. Miller, OD, MBA
Patient compliance with recommended CL wear and care schedules always could be improved. A proven compliance builder: a one-day or one-month wearing schedule.
When we prescribe contact lenses, we are careful to review the necessary wear and care schedule with patients, but as any optometrist will tell you, getting patients to follow those instructions is easier said than done. Whether due to negligence, attempted cost savings or real difficulty remembering, the two-week modality is often a hard one for patients to follow through on. Here are some of the findings in my practice of how prescribing one-day or one-month-replacement contact lenses improves patient compliance in adhering to the recommended wear and care regimen, along with tips on explaining to patients the benefits of compliance.
Proof is In: One-Day- and One-Month-Replacement CLs Enhance Compliance
According to a comprehensive study by Kathryn Dumbleton of the University of Waterloo in the UK, wearers of one-day and one-month contact lenses are more compliant than those in the two-week wear modality.
Click HERE to download a copy of the report.
Importance of Encouraging Compliance
Providing contact lens care has to include maximizing the patients’ comfort and preventing dropouts. That is definitely the ultimate goal! From the practice business perspective, improving compliance not only makes the most sense in terms of revenue, but it will also decrease ocular health complications and many comfort issues. Additionally, non-compliance with prescribed wearing regimens will directly affect the profitability of your practice.
Explain Eye Health and Comfort Affected by Non-Compliance
Non-compliance is always a challenge! Modality is an important topic to address, because patients who do not comply with their wear schedule often have comfort issues that affect their lens wearing experience. The key here is to listen to your patients and understand what they are looking for in a contact lens. Without properly educating our patients, they will often make a decision based on price. As many as 35 percent of patients don’t even wash their hands before handling their contact lenses.
From a practical perspective, recommending one-day and one-month replacement schedules just makes more sense. It seems to be easier for patients to remember to change them on time and that is what I have experienced in my office. I think this has everything to do with our busy lifestyles. Everyone seems to be going in many different directions and simplifying the wearing process will encourage more compliant behavior.
Transition Patients to One-Day or One-Month Contacts
I have patients who already wear two-week lenses and have siblings or parents who wear two-week lenses, as well. Many of those patients understand and like that replacement cycle and I do use two-week lenses for those patients. But the number of these patients is gradually decreasing in my practice, and I would estimate that about 25 percent of our patients are in two-week replacement lenses. That means about 75 percent of my patients are in one-day or one-month replacement.
Explain Need for Transition to One-Day or One-Month Contacts
I truly feel the contact lens fitting process needs to be personalized to the individual. The easiest switch is for someone wearing their two-week lenses for one-month. I educate them on newer designs and offer a lens that fits their monthly changing cycle better if that is their preferred modality. For every patient, I offer or discuss one-day lenses, and that modality is my lens of choice for all patients.
For Cost Conscious: One-Month Often Less Expensive than Two-Week Lenses
One-month replacement lenses are usually a little less expensive than two-week lenses when comparing annual supply costs. That makes it an easier switch for patients who are cost sensitive and are not willing to make the leap to one-day lenses.
One-Day Replacement a Winner for Children and Adolescents
The one-day modality makes the most sense for all children, adolescents and college students! Remembering when to change their contact lenses is rarely a high priority in the minds of young people. We should help them be compliant any way we can–and one-day replacement lenses provide just the help they need. I strongly recommend one-days to all children, teens and young adults.
Review Compliance at Every Visit
The best thing we can do for contact lens wearers is continue to educate them at every visit. Don’t assume your patients are following your recommendations. Ask them how they are wearing their contacts and educate them on the complications that can arise when they over-wear their lenses.
Have Staff Reinforce Compliance Message
It is great to have staff reinforce your prescribing habits. They can help open the discussion door prior to the doctor even coming into the room. It is also great to have staff support when comparing the cost of each modality. Remember to discuss any rebates and only compare annual supply costs.
Prescribe One-Day or One-Month Contact Lenses:
Individualize the fitting process. Most patients will prefer the one-day or one-month modality.
Offer new products. They will provide the best comfort and compliance.
If a “happy” patient says they are doing “fine,” probe a little deeper. Often times, they are taking their contacts out earlier in the evening and using re-wetting drops to maintain comfortable contact lens wear.
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Overcome the Cost Barrier: Move More Patients Into Daily Replacement CLs
Jason R. Miller, OD,has been in practice 11 yearsand is in a partnership private practice with Tamara M. Kuhlmann, OD, MS, atEyeCare Professionals of Powell, Ohio. Contact: firstname.lastname@example.org.