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1 General aspects (1)   1.1 Epidemiology (14)   1.2 Population genetics (2)   1.3 Pathogenesis (1)   1.4 Quality of life (20)   1.5 Glaucomas as cause of blindness (8)   1.6 Prevention and screening (13) 2 Anatomical structures in glaucoma (0)   2.1 Conjunctiva (10)   2.2 Cornea (23)   2.3 Sclera (16)   2.4 Anterior chamber angle (7)   2.5 Meshwork (0)     2.5.1 Trabecular meshwork (15)     2.5.2 Schlemms canal (1)     2.5.3 Scleral outlet channels (1)   2.6 Aqueous humor dynamics (0)     2.6.1 Production (0)     2.6.2 Outflow (1)       2.6.2.1 Trabecular meshwork (4)       2.6.2.2 Uveoscleral (1)     2.6.3 Compostion (6)   2.7 Episcleral veins and venous pressure (2)   2.8 Iris (6)   2.9 Ciliary body (0)   2.10 Lens (0)   2.11 Vitreous body (0)   2.12 Choroid, peripapillary choroid, peripapillary atrophy (18)   2.13 Retina and retinal nerve fibre layer (37)   2.14 Optic disc (42)   2.15 Optic nerve (2)   2.16 Chiasma and retrochiasmal central nervous system (13)   2.17 Stem cells (5)   2.20 Other (0) 3 Laboratory methods (0)   3.1 Microscopy (0)   3.2 Electron microscopy (2)   3.3 Immunohistochemistry (2)   3.4 Molecular genetics (0)     3.4.1 Linkage studies (0)     3.4.2 Gene studies (30)   3.5 Molecular biology incl. 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surgery (0)     12.8.1 Without tube implant (17)     12.8.2 With tube implant or other drainage devices (68)     12.8.3 Non-perforating (13)     12.8.4 Using laser (0)     12.8.5 Other (1)     12.8.10 Woundhealing antifibrosis (17)     12.8.11 Complications, endophthalmitis (15)   12.9 Trabeculotomy, goniotomy (25)   12.10 Cyclodestruction (11)   12.11 Cyclodialysis (1)   12.12 Cataract extraction (0)     12.12.1 Intracapsular (0)     12.12.2 Extracapsular (0)     12.12.3 Phacoemulsification (14)   12.14 Combined cataract extraction and glaucoma surgery (0)     12.14.1 Intracapsular (0)     12.14.2 Extracapsular (0)     12.14.3 Phacoemulsification (19)   12.15 Capsulotomy (0)   12.16 Vitrectomy (2)   12.17 Anesthesia (2)   12.20 Other (2) 13 Therapeutic prognosis and outcome (0)   13.1 Prognostic factors (2)   13.2 Outcome (0)     13.2.1 IOP (0)     13.2.2 Visual field (0)       13.2.2.1 Progression (0)       13.2.2.2 Improvement (0)     13.2.3 Other (0) 14 Costing studies; pharmacoeconomics (8) 15 Miscellaneous (37)

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Abstract #81889 Published in IGR 20-4

A Path Analysis of Effects of Patients' Underlying Conditions, Treatment Satisfaction, and Adherence on Quality of Life Among Korea Glaucoma Patients

Kim CY; Park KH; Ahn J; Ahn MD; Cha SC; Kim HS; Kim JM; Kim MJ; Kim TW; Kim YY; Lee JW; Park SW; Sohn YH; Sung KR; Yoo C; Cha JH; Kim YJ; Lee J; Choi J
Journal of Glaucoma 2019; 28: 785-789

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: PRéCIS: This observed patient-specific features and treatment-driven conditions that were significantly associated with the impairment of health-related quality of life (HRQOL) among glaucoma patients. The results suggest that more systematic strategies should be implemented to improve an HRQOL. PURPOSE: To determine factors contributing to an HRQOL and assess total, direct and indirect, effects that may exist between the determinants using path analysis. MATERIALS AND METHODS: Data were derived from previous Korea glaucoma outcomes research. A total of 847 glaucoma outpatients with ≤2 years of eye-drop use were included in the present study. Including factors and their hypothetical pathways to an HRQOL were based on the literature review and consultation with specialists. Age, sex, comorbidities, and education levels were included as underlying conditions and treatment patterns were defined by the number of daily instillations of prescribed eye-drops. Treatment satisfaction and adherence were estimated using a Treatment Satisfaction Questionnaire for Medication, which assessed side-effects, effectiveness, convenience, global satisfaction, and pill count. An HRQOL was assessed by EQ-5D and EQ-visual analogue scale (EQ-VAS). RESULTS: In EQ-5D analysis, male individuals showed total effects (β=0.102, P=0.0026), including both direct (β=0.076, P=0.0095) and indirect effects (β=0.0253, P=0.0020), which were mediated by treatment satisfaction in the side effects and global satisfaction categories. Higher education (β=0.197, P=0.0020) and satisfaction in the side effect (β=0.095, P=0.0076) and global satisfaction (β=0.075, P=0.0414) categories were found to have direct effects on EQ-5D. For EQ-VAS, higher education levels had significant total effects (β=0.153, P=0.0020) accounting for direct effects (β=0.131, P=0.0030) and indirect effects (β=0.0223, P=0.0531) through global satisfaction. In addition, male individuals had indirect effects (β=0.274, P=0.0165), which was indirectly mediated by satisfaction in the global satisfaction category. Comorbidity (β=-0.096, P=0.0090) and satisfaction in the effectiveness (β=0.094, P=0.0302), convenience (β=0.076, P=0.0390), and global satisfaction (β =0.144, P=0.0020) categories showed indirect effect on EQ-VAS. CONCLUSION: Higher education and better treatment satisfaction had positive effects on HRQOL both in direct and indirect ways whereas comorbidities indirectly showed negative associations with HRQOL.

Department of Ophthalmology, Institute of Vision Research, Yonsei University, College of Medicine.

Full article

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Classification:

1.4 Quality of life (Part of: 1 General aspects)
11.17 Cooperation with medical therapy e.g. persistency, compliance, adherence (Part of: 11 Medical treatment)

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