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OAW: Keep calm and carry on patching

Orthoptics Awareness Week is taking place between 1-5 June with the theme ‘Seeing the future’. In the fourth article of a five-part series, Western Australian orthoptist HOLLY BROWN discusses a unique intervention to ensure children keep patching during COVID-19.

Holly Brown.

March 2020 saw many changes across Australia due to the COVID-19 crisis. How people conducted shopping, interacted with others and accessed school and work underwent transformative change.

The outpatient ophthalmology clinic at the Perth Children’s Hospital (PCH) was no exception, after it was required to reduce face-to-face appointments for the upcoming months and re-appoint patients to phone or video consultations via telehealth. Emergency face-to-face appointments could continue.

For many orthoptists, the alarm bells would have sounded when considering their patients who were patching. Will they remember? Will they stop because they won’t be seen in clinic for possibly the next six months? If parents have run out of patches or lost their patch, how will they obtain more? And what if all the hard work is undone?

It was obvious during this crisis patching therapy could be neglected. It’s been acknowledged many parents would face hardship and stress. But it’s important to make the effort to encourage families to continue patching.

The approach at PHC was to send letters to these patients. During telehealth consultations, those currently patching were advised to continue and reminded of their patching regime and a letter sent to them. Other patients who did not have a telehealth consultation but were identified as patching were also sent a letter.

The ‘Keep Calm and Carry on Patching’ letter not only served as a reminder, but included key pieces of information such as the importance of patching, as well as key information supported by the Newsham (2002) study.

PCH also included tips on the best time for patching, what activities were not suitable and where patches could be purchased online.

The letter was a simple tool that was inexpensive, easy to implement and an effective method to remind and encourage.

The Newsham study helped motivate this approach. It investigated the ability of educational material to improve parental understanding of amblyopia and occlusion.

Newsham found that parents who received a leaflet about occlusion therapy demonstrated significantly greater knowledge (88%), compared with a control group (49%). Compliance was also found to be higher in the leaflet group.

While the PCH’s primary aim was not to improve parental knowledge, but to remind families to continue patching therapy, the Newsham findings are encouraging nonetheless.

The letter will continue to be sent, while PCH considers other methods to bolster its efforts. The hospital will also consider other patient groups that might benefit from additional information or treatment reminders.

PCH is looking forward to seeing its patients in clinic again and hopeful this modest intervention has proved beneficial.

ABOUT THE AUTHOR: Holly Brown is an orthoptist at Perth Children’s Hospital and a private ophthalmology clinic in Joondalup. She has been working in Perth as an orthoptist since graduating from La Trobe University in 2015.

Ref: Newsham, David. (2002). A randomised controlled trial of written information: The effect on parental non-concordance with occlusion therapy. The British journal of ophthalmology. 86. 787-91. 10.1136/bjo.86.7.787.

More reading: Orthoptics Awareness Week spotlights paediatric eye health