As eyecare professionals, we do our best to communicate proper eye health habits to our patients. Yet, many patients unintentionally behave in ways that can impact their eye health, like wearing contact lenses past their intended replacement schedule.
I have found that encouraging my patients to integrate their lens replacement schedules with their established habits—coupled with regular education—transforms their behavior and makes compliance a “stickier” habit.
Not adhering to contact lens replacement schedules may make patients more susceptible to adverse events like contact lens discomfort or even infections.1 In fact, the consistently high rate of non-compliance among contact lens wearers, ranging from 50% to 99%,2 solidifies the need for greater action beyond just education.
While there are many factors that contribute to a patient’s lack of compliance, a lens replacement schedule that is difficult to remember and doesn’t fit within one’s routine can be one of the primary drivers.3-4
So, what if we could encourage patients to work with the ebbs and flows of life and not against them?
Applying the “habit shaping” approach to contact lens care
To perpetually evolve the way I think, treat, and interact with patients, I frequently look for inspiration beyond the eyecare industry. In fact, the idea of selecting lens replacement schedules that align with patients’ pre-existing habits is rooted in social psychology.
Research indicates that forming new, simple habits—such as doing a sit-up before breakfast in this study’s case—can take up to 66 days to become automatic.5 Alternatively, habits responsible for preventing negative health outcomes, like contact lens compliance, may take even longer to develop.5
Social psychologists uncovered that pairing a new, desired habit with an established one, such as waking up early to build time for a morning walk or silencing your phone to journal before bed, promotes a greater association between cue and response, resulting in easier habit formation.6-7
Forming new habits and “shaping” them into our established routines becomes more seamless when we combine new habits with existing ones. Per this approach, aligning your patients’ contact lens replacement schedules with their usual habits may help them become more compliant.
If a more complex action, such as replacing one’s contact lenses, takes longer to become a habit,5 then logically, we should recommend lens replacement schedules that more naturally match up with our patients’ established routines.6-7 By pairing these habits, they can build the necessary neurological muscle memory sooner.6-7
Finding the most intuitive contact lens replacement schedule
The most intuitive replacement schedule is daily disposable, as daily disposable lenses have the highest rate of contact lens replacement compliance,8 and replacement easily aligns with patients’ established routines.
However, when daily disposable lenses are not an option for a patient, I have to dig deeper. To find the most intuitive planned replacement schedule, I ask open-ended questions in the initial fitting exam about their lifestyle routines and habits.
Some of my questions include:
- What does a typical day, week, or month in your life look like?
- What habitual activity would it be easiest for you to replace your contact lenses before or after?
Actively listening during fittings or exams can provide insight into our patients’ lifestyles. By having conversations about habits, I’m able to suggest a lens that my patients can intuitively replace every day as part of their get-ready routine or another replacement schedule that best fits their lifestyle.
While incorporating these tips and tricks has tremendously helped the way I treat patients, selecting the appropriate lens does not come without its challenges. For instance, when patients cannot afford a daily disposable lens, many doctors fit 2-week replacement lenses as an alternative.
However, most habits occur on daily, weekly, or monthly intervals—such as going to the farmer’s market every Sunday or having a monthly date with your partner or friends—with very few occurring bi-weekly. Further demonstrating habit formation’s impact on compliance, data shows that two-thirds of 2-week replacement wearers are not compliant.8
Due to cost concerns around daily disposable lenses and compliance issues with 2-week lenses, I see a substantial gap in the current market that needs to be addressed with greater innovation and perhaps even a weekly replacement option to align better with patient habits.
Exploring contact lens education, outcomes, and patient loyalty
Consistent patient education drives improved compliance, better patient outcomes,9 and bolsters our practices.10 According to research on learning retention rates, about 5% of individuals recollect information from a lecture, 10% from a reading, and 20% from a demonstration.11
While the patient is in the office we primarily focus on information about handling, safety, and hygiene management, so contact lens replacement may not stick with our patients. As a result, patients are unlikely to retain replacement schedule-related information.11 For this reason, repetition and multiple communication methods for compliance education are necessary for comprehension and implementation.
To elevate compliance communication, I recommend integrating education within the initial prescribing visit and facilitating continued open conversations around patients’ lens replacement schedules. During appointments, I actively encourage patients to share any difficulties they face with compliance, allowing us to collaboratively find practical solutions tailored to their lifestyle.
In addition to selecting a lens that aligns with their lifestyle, I utilize different methods, such as email and phone call reminders, to disseminate personalized follow-ups to remind patients of their lens replacement schedule, further reinforcing the habit outside of the office visit. We have had amazing results in building patient trust and contact lens compliance with this.
In conclusion
As patients become more compliant with their contact lens replacement schedule, they are often more satisfied with their contact lens-wearing experience because their lenses are performing as intended without compliance-related complications. This satisfaction leads to an increase in the trust they have in their provider.10
Meanwhile, trust has a strong, positive association with patient loyalty.10 Not only does this fulfill our collective mission to enhance patients’ lives, but it is the bedrock of any successful practice as we are able to increase the percentage of returning patients.
So, the next time you fit a patient for a lens, remember that the simple act of educating and encouraging them to align their lens replacement to their lifestyle can have a profound impact down the line on their health and the health of your business.
