Predictors of adherence to occlusion therapy 3 months after cataract extraction in the Infant Aphakia Treatment Study

Background Little information is available on factors that predict adherence to patching in infants. We evaluated data from the Infant Aphakia Treatment Study, a randomized clinical trial of treatment for infants with unilateral congenital cataracts, to investigate factors associated with successful adherence to patching protocols. Methods In the Infant Aphakia Treatment Study, patching was prescribed 1 hour daily per month of age until 8 months of age and 50% of waking hours thereafter. A centrally located staff member inquired about the patient’s adherence to patching in a phone interview with the primary caregiver. Analyses used χ2 tests of independence and logistic regression to identify predictors of reported adherence and of achieving adherence rates of at least 75% (“good”) and 90% (“excellent”). Results A total of 104 caregivers provided data on patching 3 months after surgery, at which time 60% reported patching at least 75% of the prescribed time. Reported adherence was not associated with the type of treatment ( P = 0.73) but was better in children with private insurance ( P = 0.01) and for children with mothers reporting lower levels of parenting stress ( P = 0.03). Conclusions Most caregivers reported being able to adhere to prescribed patching shortly after extraction of a unilateral congenital cataract. The type of correction (intraocular lens vs contact lens) was not associated with the amount of patching achieved, whereas family socioeconomic status and maternal stress appeared to play a role.