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Compliance to spectacle use in children with refractive errors- a systematic review and meta-analysis.

ABSTRACT: BACKGROUND:Primary objective of this review was to measure compliance with spectacle use in children with refractive errors. Secondary objective was to understand the reasons for non-compliance. METHODS:The databases searched were Ovid, EMBASE, CINAHL and Pubmed. All studies up to March, 2018 were included. The search terms were- ((((((Compliance [Title/Abstract]) OR Adherence [Title/Abstract]) OR Compliant [Title/Abstract]) OR Adherent [Title/Abstract])) AND (((Spectacle [Title/Abstract]) OR Spectacles [Title/Abstract]) OR Eye Glasses [Title/Abstract])) AND ((((Child [Title/Abstract]) OR Children [Title/Abstract]) OR Adolescent [Title/Abstract]) OR Adolescents [Title/Abstract]). Two researchers independently searched the databases and initial screening obtained 33 articles. The PRISMA guidelines were followed for conducting and writing the systematic review. Two reviewers assessed data quality independently using the Quality Assessment tool for systematic reviews of observational studies (QATSO). Poor quality studies were those, which had a score of less than 33% on the QATSO tool. Sensitivity analysis was done to determine if poor quality studies effected compliance. Galbraith plot was used to investigate statistical heterogeneity amongst studies. A random effects model was used to pool compliance. RESULTS:Twenty-three studies were included in the review, of which 20 were included in the quantitative analysis. All the studies were cross sectional. The overall compliance with spectacle use was 40.14% (95% CI- 32.78-47.50). The compliance varied from 9.84% (95% CI?=?2.36-17.31) to 78.57% (95% CI?=?68.96-88.18). The compliance derived in sensitivity analysis was 40.09%. Reasons for non-compliance were broken/lost spectacles, forgetfulness, and parental disapproval. CONCLUSION:Appropriate remedial measures such as health education and strengthening vision care services will be required to address poor compliance with spectacle use among children.

SUBMITTER: Dhirar N

PROVIDER: S-EPMC7038539 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Compliance to spectacle use in children with refractive errors- a systematic review and meta-analysis.

Dhirar Nonita N Dudeja Sankalp S Duggal Mona M Gupta Parul Chawla PC Jaiswal Nishant N Singh Meenu M Ram Jagat J

BMC ophthalmology 20200224 1

<h4>Background</h4>Primary objective of this review was to measure compliance with spectacle use in children with refractive errors. Secondary objective was to understand the reasons for non-compliance.<h4>Methods</h4>The databases searched were Ovid, EMBASE, CINAHL and Pubmed. All studies up to March, 2018 were included. The search terms were- ((((((Compliance [Title/Abstract]) OR Adherence [Title/Abstract]) OR Compliant [Title/Abstract]) OR Adherent [Title/Abstract])) AND (((Spectacle [Title/A ...[more]

PMID: 32093669

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Project description:PurposeTo investigate the level of compliance of children with refractive errors who are provided free spectacles, and to identify the reasons for non-compliance.MethodsWe systematically searched the PubMed, EMBASE, CINAHL, Web of Science, and Cochrane Library databases from the time these databases were established to April 2022, including studies published in English. The search terms were "randomized controlled trial" [Publication Type] OR "randomized" [Title/Abstract], OR "placebo" [Title/Abstract]) AND (("Refractive Errors"[MeSH Terms] OR ("error refractive" [Title/Abstract] OR "errors refractive" [Title/Abstract] OR "refractive error" [Title/Abstract] OR "refractive disorders" [Title/Abstract] OR "disorder refractive" [Title/Abstract] OR "disorders refractive" [Title/Abstract] OR "refractive disorder" [Title/Abstract] OR "Ametropia" [Title/Abstract] OR "Ametropias" [Title/Abstract])) AND ("Eyeglasses" [MeSH Terms] OR ("Spectacles" [Title/Abstract] OR "Glasses"[Title/Abstract]) AND ("Adolescent" [MeSH Terms] OR ("Adolescents" [Title/Abstract] OR "Adolescence"[Title/Abstract]) OR "Child"[MeSH Terms] OR "Children"[Title/Abstract])). We only selected studies that were randomized controlled trials. Two researchers independently searched the databases, and 64 articles were retrieved after the initial screening. Two reviewers independently assessed the quality of the collected data.ResultsFourteen articles were eligible for inclusion, and 11 studies were included in the meta-analysis. The overall compliance with spectacle use was 53.11%. There was a statistically significant effect of free spectacles on compliance among children (OR = 2.45; 95% CI = 1.39-4.30). In the subgroup analysis, longer follow-up time was associated with significantly lower reported ORs (6-12 vs. <6 months, OR = 2.30 vs. 3.18). Most studies concluded that sociomorphic factors, RE severity, and other factors contributed to children not wearing glasses at the end of the follow-up.ConclusionThe combination of providing free spectacles along with educational interventions can lead to high levels of compliance among the study participants. Based on this study's findings, we recommend implementing policies that integrate the provision of free spectacles with educational interventions and other measures. In addition, a combination of additional health promotion strategies may be needed to improve the acceptability of refractive services and to encourage the consistent use of eyewear.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=338507, identifier: CRD42022338507.

Project description:ObjectiveTo synthesize and appraise economic evaluations of vision screening to detect vision impairment in children.MethodsLiterature searches were conducted on seven electronic databases, grey literature, and websites of agencies conducting health technology assessments. Studies were included if they (1) were full, comparative economic evaluations that used cost-utility, cost-benefit, cost-effectiveness, cost-consequence, or cost-analysis methods; (2) described screening services designed to detect amblyopia, strabismus, or uncorrected refractive errors in children under 6 years of age; and (3) published after 1994. High-quality studies were synthesized descriptively. Currencies were reported in 2019 Canadian dollars. Quality was assessed with the Pediatric Quality Appraisal Questionnaire (PQAQ).ResultsVision screening services were conducted by paid staff, volunteers, or health care professionals in schools or clinics. Thirteen studies were published from five countries: China (n = 1), United States (n = 4), United Kingdom (n = 1), Canada (n = 1), and Germany (n = 6). Analytical techniques included cost-utility/cost-effectiveness combination (n = 2), cost-effectiveness analysis (n = 7), cost-utility analysis (n = 1), cost-benefit analysis (n = 1), cost-consequence analysis (n = 1), and cost analysis (n = 1). Incremental cost-effectiveness ratios ranged from C$1,056 to C$151,274 per additional case detected/prevented and from C$9,429 to C$30,254,703 per additional QALY gained, depending on the type of screening service and comparator. Six studies were determined to be of high quality.ConclusionVision screening to detect amblyopia for young children may be cost-effective compared with no screening if amblyopia reduced quality of life. Studies varied significantly in the type of screening services and comparators used. Methodological limitations were common. Future studies would be aided immensely by prospective studies on the impact of amblyopia on the health-related quality of life of young children and guidelines on the effective conduct of vision screening.

Project description:BackgroundMobile device-based ecological momentary assessment (mobile-EMA) is increasingly used to collect participants' data in real-time and in context. Although EMA offers methodological advantages, these advantages can be diminished by participant noncompliance. However, evidence on how well participants comply with mobile-EMA protocols and how study design factors associated with participant compliance is limited, especially in the youth literature.ObjectiveTo systematically and meta-analytically examine youth's compliance to mobile-EMA protocols and moderators of participant compliance in clinical and nonclinical settings.MethodsStudies using mobile devices to collect EMA data among youth (age ?18 years old) were identified. A systematic review was conducted to describe the characteristics of mobile-EMA protocols and author-reported factors associated with compliance. Random effects meta-analyses were conducted to estimate the overall compliance across studies and to explore factors associated with differences in youths' compliance.ResultsThis review included 42 unique studies that assessed behaviors, subjective experiences, and contextual information. Mobile phones were used as the primary mode of EMA data collection in 48% (20/42) of the reviewed studies. In total, 12% (5/42) of the studies used wearable devices in addition to the EMA data collection platforms. About half of the studies (62%, 24/42) recruited youth from nonclinical settings. Most (98%, 41/42) studies used a time-based sampling protocol. Among these studies, most (95%, 39/41) prompted youth 2-9 times daily, for a study length ranging from 2-42 days. Sampling frequency and study length did not differ between studies with participants from clinical versus nonclinical settings. Most (88%, 36/41) studies with a time-based sampling protocol defined compliance as the proportion of prompts to which participants responded. In these studies, the weighted average compliance rate was 78.3%. The average compliance rates were not different between studies with clinical (76.9%) and nonclinical (79.2%; P=.29) and studies that used only a mobile-EMA platform (77.4%) and mobile platform plus additional wearable devices (73.0%, P=.36). Among clinical studies, the mean compliance rate was significantly lower in studies that prompted participants 2-3 times (73.5%) or 4-5 times (66.9%) compared with studies with a higher sampling frequency (6+ times: 89.3%). Among nonclinical studies, a higher average compliance rate was observed in studies that prompted participants 2-3 times daily (91.7%) compared with those that prompted participants more frequently (4-5 times: 77.4%; 6+ times: 75.0%). The reported compliance rates did not differ by duration of EMA period among studies from either clinical or nonclinical settings.ConclusionsThe compliance rate among mobile-EMA studies in youth is moderate but suboptimal. Study design may affect protocol compliance differently between clinical and nonclinical participants; including additional wearable devices did not affect participant compliance. A more consistent compliance-related result reporting practices can facilitate understanding and improvement of participant compliance with EMA data collection among youth.

Project description:Introduction Globally, the prevalence of refractive error was 12%, and visual impairment due to refractive error was 2.1%. In sub-Saharan Africa, the prevalence of refractive error and visual impairment due to refractive error was 12.6% and 3.4%, respectively. In Ethiopia, the prevalence of visual impairment due to refractive error varies from 2.5% in the Gurage zone to 12.3% in Hawassa city. Hence, this Meta-analysis aimed to summarize the pooled prevalence of visual impairment due to refractive error in Ethiopia. Methods A systematic search of the literature was conducted by the authors to identify all relevant primary studies. All articles on the prevalence of visual impairment due to refractive error in Ethiopia were identified through a literature search. The databases used to search for studies were PubMed, Science Direct, POPLINE, HENARI, Google Scholar, and grey literature was searched on Google until December 15, 2021. In this meta-analysis, the presence of publication bias was evaluated using funnel plots and Begg’s tests at a significance level of less than 0.05. The sensitivity analysis was conducted to check for a single study’s effect on the overall prevalence of refractive error. Result About 1664 studies were retrieved from initial electronic searches using international databases and google searches. A total number of 20,088 children and adolescents were included in this meta-analysis. The pooled prevalence of visual impairment due to refractive error in Ethiopia using the random effects model was estimated to be 6% (95% CI, 5–7) with a significant level of heterogeneity (I2 = 94.4%; p < 0.001). The pooled prevalence of visual impairment due to refractive was analyzed by subtypes, and pooled prevalence was estimated to be 4%, 5.2%, and 1% for myopia, hyperopia, and astigmatism, respectively. Conclusion The pooled prevalence of visual impairment due to refractive error was high in Ethiopia. About one in twenty-five Ethiopian children and adolescents are affected by visual impairment due to myopia.

Project description:Inhaler device errors are common and may impact the effectiveness of the delivered drug. There is a paucity of up-to-date systematic reviews (SRs) or meta-analyses (MAs) of device errors in asthma and chronic obstructive pulmonary disease (COPD) patients. This SR and MA provides an estimate of overall error rates (both critical and non-critical) by device type and evaluates factors associated with inhaler misuse. The following databases from inception to July 23, 2014 (Embase®, MEDLINE®, MEDLINE® In-Process and CENTRAL) were searched, using predefined search terms. Studies in adult males and females with asthma or COPD, reporting at least one overall or critical error, using metered dose inhalers and dry powder inhalers were included. Random-effect MAs were performed to estimate device error rates and to compare pairs of devices. Overall and critical error rates were high across all devices, ranging from 50-100% and 14-92%, respectively. However, between-study heterogeneity was also generally >90% (I-squared statistic), indicating large variability between studies. A trend towards higher error rates with assessments comprising a larger number of steps was observed; however no consistent pattern was identified. This SR and MA highlights the relatively limited body of evidence assessing device errors and the lack of standardised checklists. There is currently insufficient evidence to determine differences in error rates between different inhaler devices and their impact on clinical outcomes. A key step in improving our knowledge on this topic would be the development of standardised checklists for each device.CALL TO STANDARDISE RESEARCH INTO INHALER DEVICE ERRORS: Researchers should adopt a standardised approach to investigate the incorrect use of inhalers and its associated clinical implications. Henry Chrystyn at Plymouth University, together with scientists across the UK and the Netherlands, conducted a review of research related to inhaled medication errors made by patients with asthma or chronic obstructive pulmonary disease. It is widely acknowledged that many patients with lung conditions don't use their inhaler devices correctly, which affects drug effectiveness and disease control. While Chrystyn's team found high critical error rates reported across all devices, their meta-analysis and systematic review highlighted significant gaps in knowledge regarding different inhalers and associated error rates, and how these affect clinical outcomes. The researchers call for in-depth studies into device use, alongside standardised checklists and definitions for such studies to use to ensure consistency.

Dataset Information

Compliance to spectacle use in children with refractive errors- a systematic review and meta-analysis.

Publications

Compliance to spectacle use in children with refractive errors- a systematic review and meta-analysis.

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