Aim: To analyse psychological causes for low compliance with occlusion therapy for amblyopia. Method: In a randomised trial, the effect of an educational programme on electronically measured compliance had been assessed. 149 families who participated in this trial completed a questionnaire based on the Protection Motivation Theory after 8 months of treatment. Families with compliance less than 20% of prescribed occlusion hours were interviewed to better understand their cause for non-compliance. Results: Poor compliance was most strongly associated with a high degree of distress (p<0.001), followed by low perception of vulnerability (p = 0.014), increased stigma (p = 0.017) and logistical problems with treatment (p = 0.044). Of 44 families with electronically measured compliance less than 20%, 28 could be interviewed. The interviews confirmed that lack of knowledge, distress and logistical problems resulted in non-compliance. Conclusion: Poor parental knowledge, distress and difficulties implementing treatment seemed to be associated with non-compliance. For the same domains, the scores were more favourable for families who had received the educational programme than for those who had not.

dx.doi.org/10.1136/bjo.2008.149815, hdl.handle.net/1765/24884
British Journal of Ophthalmology: a peer review journal for health professionals and researchers in ophthalmology
Erasmus MC: University Medical Center Rotterdam

Loudon, S.E, Passchier, J, Chaker, L, de Vos, S, Fronius, M, Harrad, R.A, … Simonsz-Tóth, B. (2009). Psychological causes of non-compliance with electronically monitored occlusion therapy for amblyopia. British Journal of Ophthalmology: a peer review journal for health professionals and researchers in ophthalmology, 93(11), 1499–1503. doi:10.1136/bjo.2008.149815