Effectiveness of Mobile Application Use on the Compliance & Behavior of Soft Contact Lens Wearers in the Occupied Palestinian Territories رسالة ماجستير

Abstract

Background Contact lens compliance is the adherence of contact lens wearers with the recommendations and instructions provided by eye care practitioners. Contact lenses wearers who exhibit poor compliance behavior with contact lens care and wear instructions are more likely to have ocular complications. Current strategies to enhance contact lens compliance behavior are limited. The standard method is patient education either verbally, or through written instructions that are reinforced with photos, or videos, or booklets. Generally, one of the strategies that is used to enhance patients’ compliance in health sector is mHealth apps. mHealth apps have been utilized to ensure continuity of care, and change poor health behaviors, it is worth to assess its effectiveness in improving compliance of contact lens wearers. Objective To assess the effectiveness of mHealth app (LENSA) in improving compliance and healthy behaviors among soft contact lens wearers in the Occupied Palestinian Territories. Methodology A quasi- experiment design that use pre-/ post-intervention and a comparable control group was utilized. The data collection was conducted using a questionnaire that was designed to assess the level of compliance on both the intervention group and the control group. The intervention group was trained on the use of mHealth app LENSA, and received written instruction on the care and wear of contact lenses, while the control group received only verbal instructions. The level of compliance for the intervention and control groups were measured and compared at the end of the study to evaluate the effect of the intervention. vi Results A total of 201 participants completed the study. One hundred and four participants (104) were enrolled in the intervention group, while ninety-seven participants (97) were in the control group. The mean age of participants was 27.4 ± 7.38 years, and 91.5% of them were females, and 48.3% of participants held bachelor degree. There was a statistically significant increase in the compliance scores in fourteen out of twenty lens care behaviors for the intervention group, and in eight out of twenty lens care behaviors for the control group (Wilcoxon Signed Ranks Test, p<0.05). LENSA app was effective in improving only one lens care behavior “daily wearing time of contact lenses’’ (Mann Whitney U Test, p-value=0.03). The average level of compliance for both groups post-intervention was 80.6%, compared to 45.3% compliance level pre-intervention. Conclusion Although there was no difference between the instructions delivered through enhancement strategy/written instruction and the standard verbal instructions, LENSA app confirmed its effectiveness in controlling daily wearing hours with a significant difference between the intervention and the control group, in addition to the improvement in the compliance of other behaviors despite their non- significance. Further studies are needed to assess the effectiveness of mHealth app for longer periods of time, using a large sample size and other types of contact lenses