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Editors Selection IGR 9-4

Miscellaneous: Digital Technology, Online Resources and Treatment Adherence

Comment by Ivan Goldberg on:

76984 Access to and Experiences with e-Health Technology Among Glaucoma Patients and Their Relationship with Medication Adherence, Newman-Casey PA; Killeen OJ; Renner M et al., Telemedicine Journal and E-Health: the Official Journal of the American Telemedicine Association, 2018; 0:

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'As online health information becomes common, it is important to assess patients' access to and experiences with online resources,' state Dr Newman-Casey and co-workers as they set out to determine glaucoma patient use of internet information strategies and to test whether or not such usage links with medication adherence.

In this prospective survey, the authors recruited 164 glaucoma patients prescribed at least one topical medication from two glaucoma clinics (in Ann Arbor, Michigan and Baltimore, Maryland). Patients completed a questionnaire that covered demographics (age, sex, location, level of education), disease characteristics (duration of glaucoma treatment, number of glaucoma medications, number of other chronic medical conditions as well as subjective assessment of overall health and vision status), self-reported adherence to their glaucoma treatment and technology usage (access to the internet at home, frequency and usage of the internet, use of a smart phone along with use of technology to access glaucoma information or at least interest in such access).

With a mean age of 66 years, results from this glaucoma patient cohort included: 26% self-reported non-adherence, older patients were more likely to be adherent and there was no demonstrated association between technology use and adherence. Unsurprisingly, older patients were less likely to access the internet or to use cell phones and were less likely to wish to receive information about glaucoma via emails, text messages or through the internet. Of particular interest, those patients who self-reported poorer adherence were more likely to have had a negative experience the last time they had searched for glaucoma resources on-line and/ or to have been confused by the material accessed. Reported too was the lack of emotional support patients received if and when they used internet access.

An increasing proportion of glaucoma patients wish to expand their understanding of their condition online but yet are not being guided by their ophthalmologists to helpful, worthwhile and quality internet resources

While accepting their study's limitations (self-reported, patient cohort a convenience sample, absence of chart verification or determination of glaucoma severity), the authors note an increasing proportion of glaucoma patients wish to expand their understanding of their condition on-line and yet are not being guided by their treating ophthalmologists to helpful, worthwhile and quality internet resources. They stress the opportunity awaiting us all to continue to develop and to guide our patients towards such sites.

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