This issue, OP asked for practice tips concerning scripts ophthalmic professionals use to determine and help facilitate patient compliance.

In addition to our Clinical Visit Summaries, our electronic health record makes a very efficient process of sending examination reports primary care physicians and other eye specialists. Getting this follow up data to our patients’ other care givers helps to ensure the right instructions are reinforced continually for best compliance and patient support.

Printing out a clinical visit summary is a great way to facilitate patient compliance. Patients review their treatment plans at home to ensure that they’re following the doctor’s orders correctly, instead of relying on their memory. This is especially helpful for the elderly, those with memory issues, and for those who have complex treatment plans, such as several different topical glaucoma medications. Printing out clinical visit summaries has also benefitted our practice as we get less calls from patients asking if they’re taking their eye drops correctly.

Monitoring and ensuring patient compliance is one of our staff’s greatest challenges. When asked by the physician if they are taking their drops, patients usually dutifully nod.

Determining compliance can tricky, since many patients are reluctant to admit they are less than 100% compliant. Cristobal Cruz, MD, a glaucoma surgeon in our practice, puts a different spin on the issue of determine drop compliance. He asks: “How many times do you miss your drops in a week?” By looking for a negative rather than a positive, he makes it safe for patients to give an honest response and reduces the opportunity for patients to deny missing medication.

When it comes to ensuring patient compliance, Dr. Cruz stresses education. He believes that by partnering with his patients and making sure they truly understand their disease, compliance is improved overall. Sometimes this takes persistence and patience. His staff explains the duration of each medication so patients are more likely to take their drops on schedule. For example, a twice per day drop has a 12 hour duration, while a once per day drop has a 24 hour duration.

Finally, we are piloting the “teach back” method. After reviewing glaucoma and directions for new medications, it is common to ask, “do you have any questions?” A more effective method to verify understanding would be to say, “in order to make sure I’ve explained glaucoma clearly, could you please tell me what you now understand about glaucoma?”