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Abstract #22276 Published in IGR 10-4
Predictors of and barriers associated with poor follow-up in patients with glaucoma in South India
Lee BW; Sathyan P; John RK; Singh K; Robin ALArchives of Ophthalmology 2008; 126: 1448-1454
See also comment(s) by Ravi Thomas •
OBJECTIVES: To determine predictors of and reasons for poor longitudinal glaucoma follow-up in South India. METHODS: This 1-to-1, matched, case-control study enrolled 300 patients with established glaucoma. We defined cases (poor follow-up) and controls (good follow-up) based on number of and maximum interval between glaucoma follow-up visits attended in the preceding year. We collected data by oral questionnaire and used stepwise multivariate logistic regression to calculate odds ratios (ORs) for poor follow-up. RESULTS: Adjusting for age and sex, independent predictors of poor follow-up included lack of formal education (adjusted OR, 4.13; 95% confidence interval [CI], 1.44-11.90), no use of prescribed glaucoma medications (adjusted OR, 2.17; 95% CI, 1.06-4.43), and belief that follow-up is less important if one uses glaucoma medications and has no noticeable visual changes (adjusted OR, 10.59; 95% CI, 3.74-29.97). Age, sex, and disease severity were not significant predictors. The most prevalent barriers to follow-up were belief that there was no problem with one's eyes (44.4%) and lack of escort (19.7%). CONCLUSIONS: Knowing predictors of poor follow-up can help identify patients who need individualized strategies to improve follow-up. Because believing one's eyes are problem-free and lacking escorts are significant barriers to follow-up, novel strategies in patient education (e.g., intensive counseling, audiovisual aides, and patient support groups) and escort provision may improve longitudinal glaucoma follow-up and disease management.
Dr. B.W. Lee, Department of Ophthalmology, Stanford University, Palo Alto, CA 94306, USA. bradford.lee@stanford.edu
