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S.E. Loudon, B.L. Verhoef, M.V. Joosse, M. Fronius, M. Awan, D. Newsham, R.A. Harrad, H.J. Simonsz; Electronic Recording of Patching for Amblyopia Study (ERPAS): Preliminary Results . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4246.
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Purpose: One third of the treatments for amblyopia fails, mainly caused by non-compliance. Therefore, in this prospective randomised study, predictors for non-compliance are identified and the effect of a programme to enhance compliance will be assessed. Methods: Since July 2001 all newly diagnosed amblyopic children in The Hague are recruited by 8 orthoptists. From January 2003 additional children are recruited in Frankfurt, Leicester, Liverpool and Bristol. Compliance is measured electronically during 1 week every 3 months with the Occlusion Dose Monitor, distributed by house-visits. The social economic and ethnical backgrounds as well as the decrease in the quality of life during patching is assessed. After 6 months reasons of failure or success of the occlusion therapy are identified with the Patching Success Questionnaire. Half of the included children receive, in addition to standard orthoptic care, a compliance-enhancing programme developed for children of any ethnic or social economic background, consisting of a self-explanatory cartoon and bolstered by a direct reward system administered by the parents. The control group receives a colouring plate. Results: 79% of 230 eligible children have been included, mean age is 4.4. 48% are of foreign origin. Overall compliance averaged 63%. 10% of the children are teased when wearing the patch and 25% of the parents do not like the look of their child wearing a patch. 75% finds it difficult fitting the therapy into their daily routine. 25% do not know the exact aim of the treatment and 50% would prefer patching their child at an older age. Conclusions: Despite the fact that parents knew patching was monitored, average compliance was low. Logistical factors, poor knowledge and the perceived social barriers by the parents seem to be important determinants for compliance. Assessment of the compliance-enhancing programme will be performed after recruitment has been concluded.
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