title: Exploring compliance: a mixed-methods study of contact lens wearer perspectives.
abstract: OBJECTIVE
  Using both quantitative and qualitative research methods, this article explores in detail the lens wear and care habits of adapted contact lens wearers and seeks a better understanding of what enables and constrains patient compliance with appropriate lens wear and lens care.
  
  
  METHODS
  The study was conducted in two phases: a preliminary online questionnaire (quantitative phase), identifying types of noncompliance, and a series of sequentially conducted focus groups (qualitative phase), exploring constraints to, and enablers of, compliance.
  
  
  RESULTS
  One hundred participants completed the online questionnaire; 12 of them also participated in one of four focus groups. The most frequently reported aspects of noncompliance revealed were failure to replace lenses when scheduled, inappropriate lens purchase and supply, sleeping while wearing lenses, use of tap water with lenses and failure to wash hands, failure to clean and replace cases regularly, and inappropriate use of care systems. Using an iterative process, a number of "themes" associated with noncompliance were identified in the focus group discussions. The most frequently occurring themes related to the consequences that may occur if patients were noncompliant with one or more aspects of their contact lens wear and the importance of receiving instructions regarding the most appropriate way to wear and care for their lenses. Most of the themes that emerged during the analysis were both constraints to, and enablers of, compliance.
  
  
  CONCLUSIONS
  This study confirms the frequent types of noncompliance with contact lens wear and care while offering a greater understanding of what may constrain and enables contact lens wear and care compliance. Future qualitative studies may help eye care practitioners and the contact lens industry to develop strategies and tools to aid compliance and success in contact lens wear.
authors.affiliation: Centre for Contact Lens Research, School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada. kdumble@uwaterloo.ca
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Dumbleton
authors.forename: Marlee M
authors.initials: MM
authors.lastname: Spafford
authors.forename: Alisa
authors.initials: A
authors.lastname: Sivak
authors.forename: Lyndon W
authors.initials: LW
authors.lastname: Jones
mesh_terms: D018639:Contact Lens Solutions / Q000627:therapeutic use*; D003261:Contact Lenses / Q000706:statistics & numerical data; D004209:Disposable Equipment; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D018639:Contact Lens Solutions