Clinicians may improve follow-up adherence by leveraging social media apps

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A new Chinese report recognised that social media smartphone application–based interventions significantly improved follow-up adherence and increased parental knowledge among families of children with congenital ectopia lentis,¹ according to Yiyuan Ma, MD, who is from the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.

Congenital ectopia lentis is a rare ocular disease characterised by the dislocation or displacement of the lens.²

The disease is most often attributed to disorders that disrupt the fibrillin-rich microfibrils of the ciliary zonule, affecting its structure and function. Ectopia lentis usually results in reduced visual acuity due to induced refractive error in the first instance. The most common causes of ectopia lentis include Marfan syndrome and related type-1 fibrillinopathies, trauma, homocystinuria and Weill–Marchesani syndrome. In addition to the refractive effects, subluxation or luxation can lead to sectoral shallowing of the anterior chamber, subluxation of the lens into the anterior chamber and glaucoma.³

Ma and colleagues emphasised that ectopia lentis requires rigorous postoperative follow-up to reduce the risk of severe complications. However, follow-up rates often can be suboptimal, indicating an urgent need for effective interventions to improve adherence.¹

To fill this gap, the investigators assessed the effect of WeChat (Tencent Holdings Ltd.), a social media smartphone communication application, which delivers telephone reminders and health education to improve the families’ adherence to postoperative follow-up of children with congenital ectopia lentis.

They conducted a randomised clinical trial (NCT05628129) at the Zhongshan Ophthalmic Center, a tertiary ophthalmic hospital in Guangzhou that included families with children who were scheduled for lens surgery to address congenital ectopia lentis. The families were randomised to either the social media group of the standard care group.

The parents were contacted before the scheduled appointments at 1 week, 1 month and 3 months postoperatively, and at those times those randomised to the social media intervention group received phone reminders and health education via the smartphone application. The main outcome was the follow-up attendance at 3 months postoperatively.

Adherence to social media reminders

The study included 110 children (58.2% males) divided equally into two study groups.

The investigators reported, “The intervention group exhibited higher attendance rates than the standard-care group across all three postoperative follow-up visits (3 months: 83.6% vs 41.8%; 1 month: 81.8% vs 58.2%; and 1 week: 92.7% vs 87.3%, respectively).”

The difference at the 3-month evaluation reached significance (P < 0.001).

The children in the social media group also had greater improvements in the accurate parental knowledge about congenital ectopia lentis (10.6%, 95% CI, 7.8%-13.5%) and higher rates of amblyopia treatments (RR, 2.40; 95% CI, 1.26-4.56).

“The results of this randomised clinical trial reveal that social media smartphone application–based interventions significantly improved follow-up adherence and increased parental knowledge among families of children with congenital ectopia lentis. These findings suggest that integrating mobile health technologies into standard care can enhance the management of progressive paediatric conditions with systemic risks, ultimately improving clinical outcomes,” Ma and colleagues concluded.

References

1. Ma Y, Zhang X, Jin L, et al. Social media interventions and postoperative follow-up in congenital ectopia lentis. A randomized clinical trial. JAMA Ophthalmol. Published online April 10, 2025. doi:10.1001/jamaophthalmol.2025.0526

2. Xu P, Ng K, Jin L, et al. Visual prognosis and complications of congenital ectopia lentis: study protocol for a hospital-based cohort in Zhongshan Ophthalmic Center. BMJ Open. 2023;13:e072542. doi: 10.1136/bmjopen-2023-072542

3. Lambert SR, Lyons CJ, eds. The lens. Taylor and Hoyt’s Pediatric Ophthalmology and Strabismus. 2017;Chapter 36, 5th ed., pp.337-345.e1; Elsevier, Amsterdam, the Netherlands; https://doi.org/10.1016/B978-0-7020-6616-0.00036-0