BACKGROUND
Myopia is an underappreciated but profound public health problem. Orthokeratology (OK) lens wear is an effective modality to inhibit axial elongation in children with myopia. Willingness for a commitment from both parents and children contributes significantly to the success of the OK treatment and decreases the chance of complications due to non-compliance behaviors.
OBJECTIVE
The aim of this pilot study was to develop and assess the usability of a mobile application of OK lens by quantitatively and qualitatively evaluating parents with myopic children and eye care professionals (ECPs). We subsequently identified and resolved individual-specific usability issues to improve future implementation of the app protocol for parents and ECPs to collaboratively manage myopic children wearing OK lens.
METHODS
The app was developed and tested in 2020 using a co-design approach involving target users (parents with 7-13 myopic children), ECPs, designers, and app developers. A total of 36 parents with children who were given OK lens in an ophthalmology clinic were admitted to the study. Subsequently, prototype tests, two System Usability Scale (SUS) questionnaire surveys, and app engagement and app experience interviews were conducted during the three-month feasibility and utility assessment.
RESULTS
The app features include self-reported compliance documentation, analytics, personalized and generalized messages for compliance behaviors of orthokeratology lens. After the three-month trial period, the app demonstrated a usage rate of approximately 40 – 60 % among the 30 enrolled parents and was most often used prior to the follow-up visit. Although after the implementation of the app, there was no significant difference in compliance of wear and care, the incidence of comorbidities as well as the compliance with follow-up visits substantially improved. The average SUS scores at the first week and the third month were 54.6 and 82.0, respectively. Qualitative data suggested that parents were most satisfied with the app’s reminder and axial length recording functions, although it was recommended that the number of compliance behavior questions should be reduced to minimize the time required to complete the survey. In addition, whether the recording of the axial length data as well as the management and reminder for the follow-up visit should be completed by parents or ECPs remained controversial.
CONCLUSIONS
This is the first app developed to improve the parents’ compliance of myopic children with OK lens and assist ECPs and parents to collaboratively monitor and manage the wearing and caring of OK lens among myopic children as well as their follow-up visits. The study also highlighted the importance of interdisciplinary collaboration in the design, development, and validation of such an app.
CLINICALTRIAL
Nil