title: Assessing interventions to increase compliance to patching treatment in children with amblyopia: a systematic review and meta-analysis.
abstract: OBJECTIVE
  Amblyopia is the most common condition affecting visual acuity in childhood. Left untreated it will not resolve itself, leading to increased risk of blindness. Occluding the good eye with a patch is a highly effective treatment if carried out before age 7 years but compliance is a major problem. This systematic review addresses the question: How effective are existing interventions at increasing compliance to patching treatment in children with amblyopia?
  
  
  METHODS
  Electronic searches were carried out in June 2014 and updated in April 2015 to identify studies reporting primary data on interventions to increase patching compliance. Data screening, extraction and quality ratings were performed independently by two researchers.
  
  
  RESULTS
  Nine papers were included. Interventions including an educational element (5 studies) significantly increased patching compliance and had higher quality ratings than interventions that changed aspects of the patching regime (3 studies) or involved supervised occlusion (1 study). Meta-analysis was conducted on four studies and indicated that overall interventions involving an educational element have a significant small effect r=0.249, p<0.001.
  
  
  CONCLUSIONS
  Interventions to increase patching compliance should include educational elements. High quality research is needed to further assess the effectiveness of specific elements of educational interventions and additional behaviour change techniques.
authors.affiliation: School of Psychology, Sport and Exercise, Staffordshire University, Stoke-on-Trent, UK.
authors.forename: Sarah Elizabeth
authors.initials: SE
authors.lastname: Dean
authors.affiliation: School of Psychology, Sport and Exercise, Staffordshire University, Stoke-on-Trent, UK.
authors.forename: Rachel Clare
authors.initials: RC
authors.lastname: Povey
authors.affiliation: School of Psychology, Sport and Exercise, Staffordshire University, Stoke-on-Trent, UK.
authors.forename: Jessica
authors.initials: J
authors.lastname: Reeves
mesh_terms: D000550:Amblyopia / Q000628:therapy*; D001458:Bandages; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D009988:Orthoptics / Q000295:instrumentation* / Q000379:methods; D010349:Patient Compliance; D012683:Sensory Deprivation; D013997:Time Factors; D014792:Visual Acuity
keywords: Child health (paediatrics); Treatment other; Vision