title: An educational intervention to improve adherence  to high-dosage patching regimen for amblyopia:  a randomised controlled trial.
abstract: BACKGROUND
  Previous reports suggest that adherence to patching is a major issue in amblyopia treatment. We tested with an unmasked randomised controlled clinical trial whether an intense educational/motivational intervention improves adherence when a high-dose regime is prescribed.
  
  
  METHODS
  62 children with newly diagnosed amblyopia were randomly allocated into two treatment arms with and without educational/motivational intervention material. Both were prescribed patching 10 h/day, 6 days/week for a fixed period of 12 weeks. The intervention arm received an educational/motivational intervention before patching which included information booklets, video, a cartoon story book, sticker charts and a dedicated session with a researcher. The control arm received the usual clinical information. The primary outcome measure was adherence measured using electronic occlusion dose 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. Visual outcome, expressed as percentage visual deficit, was measured as secondary outcome.
  
  
  RESULTS
  The intervention increased adherence success rate from 45.2% in the control group to 80.6% in the intervention group (p=0.0027). However, visual outcome was not significantly better in the intervention group (p=0.190).
  
  
  CONCLUSIONS
  Our study shows that an intense educational/motivational intervention can improve adherence to patching to high prescribed doses although no significant improvement in visual outcome was observed. TRIALS REGISTRATION NUMBER: ISRCTN05346737 (International Standard Randomised Controlled Trial Number Register).
authors.forename: Archana
authors.initials: A
authors.lastname: Pradeep
authors.forename: Frank Antony
authors.initials: FA
authors.lastname: Proudlock
authors.forename: Musarat
authors.initials: M
authors.lastname: Awan
authors.forename: Glen
authors.initials: G
authors.lastname: Bush
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Collier
authors.forename: Irene
authors.initials: I
authors.lastname: Gottlob
mesh_terms: D000550:Amblyopia / Q000628:therapy*; D001458:Bandages; D002359:Cartoons as Topic; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009042:Motivation; D009988:Orthoptics / Q000295:instrumentation; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010353:Patient Education as Topic / Q000379:methods*; D012683:Sensory Deprivation; D013664:Teaching Materials; D013997:Time Factors; D016896:Treatment Outcome; D006113:United Kingdom; D015348:Vision, Binocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology