The Role of Peer Support Groups in Compliance with Occlusion Therapy Among Children with Amblyopia

Abstract

Purpose : While the current gold standard of treatment for amblyopia is occlusion therapy, social and behavioral barriers affect compliance. Previous studies have validated the Amblyopia Treatment Index (ATI) as a tool to assess the impact of patching. This project uses the ATI to assess the effectiveness of amblyopia support groups in helping improve eye patch therapy compliance.

Methods : Forty-seven children actively using occlusion therapy were invited to attend a monthly support group. An anonymous survey regarding compliance, social stigmas, and adverse reactions to occlusion therapy was given at the initial meeting, at three months, and at six months. Each month parents took part in an educational curriculum taught by a pediatric ophthalmologist and/or pediatric optometrist and provided support for one another. The children had the opportunity to socialize, while patched, with other children who were patching. All survey data was analyzed using REDCap and SAS version 9.4.

Results : To date, 22 participants have been enrolled: 9 have attended support group sessions for six months, 6 have reached the three-month milestone, and the remaining 7 have attended less than three sessions. The median age of the pediatric participants is 5 years (SD=2, range 2-10). Roughly 45% (10) were new to patching within the past year, 23% (5) had been patching between 1-2 years, and 31% (7) had been patching for more than 2 years. Participants who attended six consecutive monthly meetings reported improvement with compliance and decreased adverse effects of treatment, however, the social stigmas of patching remain unchanged. At the start of the study, only 44% (4) of the participants were meeting their target patching time; at the end, all participants had increasing patching time and 89% (8) were reaching their prescribed target goals. At baseline, 78% (7) of participant’s reported patching created tension between them and their child, this decreased to 56% (5) at 6-months. At baseline, 67% (6) of parents worried that their child was not getting enough treatment, this decreased to 22% (2) at 6-months.

Conclusions : Our preliminary evidence shows an increase in compliance for children and their families who participate in an amblyopia patch therapy support group. Although this research is ongoing, by May 2017 we expect to have final data available for all participants.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.