A study of patient compliance in a contact lens-wearing population

The incidence of corneal infections among the almost 20 million Americans who wear contact lenses, while still small, is rising rapidly. Patient non-compliance with instructions for proper lens care is partly at fault. The general phenomenon of patient non-compliance has been widely studied, most often by using the Health Belief Model (HBM). We report here on 50 consecutive patients fit with contact lenses by one ophthalmologist who were questioned by telephone regarding their lens care practices and beliefs. Forty-four percent of this group wore contact lenses for therapeutic reasons; the remainder wore them for either cosmetic reasons (34%) or convenience (22%). Adherence to published lens care guidelines was used as a basis for segregating patients into a compliant and a non-compliant group. By the criteria selected, 46% of the sample was non-compliant in their lens care. An analysis of responses from each group was structured in terms of HBM dimensions. Our aim was to determine whether there were differences in the beliefs held by compliant vs. non-compliant patients. Age under 30 and obtaining lenses for cosmetic or convenience reasons were the two variables statistically associated with non-compliant behavior. At least one undesirable belief representing each of the four HBM dimensions was found to be positively correlated with non-compliant lens use. The HBM is an effective model with which to investigate the relationship between non-compliant behavior and the rise in contact lens-related complications.