Patient education strategies in cataract surgery: A systematic review.

OBJECTIVE: To systematically review the comparative effectiveness of patient education strategies in cataract surgery.

METHODS: A comprehensive literature search of five electronic databases was conducted for randomized controlled trials (RCTs) studying the efficacy of educational interventions for cataract surgery patients. Peer-reviewed articles published in English were considered for inclusion without restriction limits on publication date. General study characteristics, measurement methodologies, and outcome measures were narratively synthesized. Quality appraisal was conducted using the Oxford quality rating system (for individual studies) and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) guidelines (for bodies of evidence).

RESULTS: Sixteen RCTs were compiled for qualitative review. We identified 21 distinct patient outcomes, four (19%) with a multi-study evidence base: knowledge of cataracts/cataract surgery, knowledge of postoperative care, proficiency in postoperative care, and anxiety. Targeted interventions significantly increased educational efficacy in 11 (69%) studies, but there were consistent improvements only for patient understanding of cataracts/cataract surgery and postoperative care. Quality of evidence was poor for all outcomes examined in multiple studies, as well as for deciding to undergo cataract surgery (measured in one study). Cross-study examination revealed appreciable clinical and methodological heterogeneity.

CONCLUSIONS: Targeted interventions fostered patients' understanding of cataract surgery and postoperative care. Additional high-quality studies are needed to determine appropriate educational strategies that improve other clinical, performance, and humanistic outcomes.