1
|
Wasser LM, Bear TM, Sommers M, Cassidy J, Muir KW, Williams AM. Barriers to Care Among Glaucoma Patients With a Missed Appointment and Interest in a Navigator Program. J Glaucoma 2024; 33:297-302. [PMID: 37974342 PMCID: PMC10954418 DOI: 10.1097/ijg.0000000000002330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 10/15/2023] [Indexed: 11/19/2023]
Abstract
PRCIS Most glaucoma patients with missed appointments report barriers to care and social risk factors. One third expressed interest in engaging with a patient navigator program. Most expressed interest in rescheduling. PURPOSE The purpose of this study was to identify barriers to care among glaucoma patients with missed appointments and to assess their interest in a patient navigator program. MATERIAL AND METHODS A cross-sectional study involving adult glaucoma patients from an academic eye center who missed their scheduled appointment between April 18 and July 25, 2022. Participants were surveyed about reasons for missed appointments, barriers to care, social risk factors, and interest in consulting with our patient navigator program. RESULTS Of 172 patients with a missed glaucoma appointment, 73% (126/172) were contacted, and 40% (51/126) of those completed the survey. Participant age averaged 67±14 years, half were female (25/51, 49%), and most identified as Black (27/51, 53%) or White (21/51, 40%). Barriers to seeing a doctor including difficulty scheduling appointments (13/51, 26%), transportation (12/51, 24%), and cost or insurance barriers (8/51, 16%). Twenty-eight (55%) respondents reported at least one social risk factor. A positive association was found between having at least one risk factor and expressing interest in consulting our patient navigator (odds ratio=6.7, P =0.009). Overall, a third of respondents expressed interest in engaging with our patient navigator program (17/51, 33%). Two thirds of participants reported awareness of missed appointments (34/51, 67%), of whom 35% (12/34) reported having already rescheduled, 41% (14/34) expressed interest in rescheduling, and 24% (8/34) did not wish to return. CONCLUSIONS Glaucoma patients with missed appointments report barriers to care and face social risk factors. Telephone outreach may help to re-engage them with care, and patients expressed interest in a patient navigator program to address social needs.
Collapse
Affiliation(s)
- Lauren M. Wasser
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Department of Ophthalmology, Shaare Zedek Medical Center Affiliated with the Hebrew University, Hadassah School of Medicine, Jerusalem, Israel
| | - Todd M. Bear
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh; and Department of Family Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Matthew Sommers
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Julie Cassidy
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Kelly W. Muir
- Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina; and Durham Veterans Affairs Medical Center, Health Services Research and Development, Durham, North Carolina
| | - Andrew M. Williams
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| |
Collapse
|
2
|
Green N, Miller F, Khanna D. Barriers to Eye Care for Adults in the United States and Solutions for It: A Literature Review. Cureus 2024; 16:e59071. [PMID: 38800137 PMCID: PMC11128266 DOI: 10.7759/cureus.59071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 04/26/2024] [Indexed: 05/29/2024] Open
Abstract
Vision loss and blindness is a significant public health concern that has had a profound impact on various communities in the United States. Both anticipated and unforeseen barriers have been linked to the rising rates of vision loss and blindness in the country. Extensive research has identified numerous barriers that put many Americans at a disadvantage when trying to seek high-quality eye care services. Not only do the barriers to eye care services create problems for eye health, but also create a poor quality of life. Therefore, understanding and identifying barriers to eye healthcare services is incredibly important. In addition to understanding and identifying barriers, it is also important to identify solutions to the problems created by these barriers. A systematic review of articles characterizing the barriers to eye care was completed which resulted in the identification of the major barriers that affect Americans. The review of previous research was also used to identify available solutions for problems associated with the barriers to eye care services. The major barriers identified were cost, insurance, transport and accessibility, eye health care literacy, and communication. Because of the identification of the major barriers, solutions were also identified. Health education and increased vision screenings were found to be the most used forms of solutions by healthcare professionals promoting good eye health. Telemedicine has also been cited as a possible solution to the growing problem of visual impairment and blindness within the American population.
Collapse
Affiliation(s)
- Nicholas Green
- Public Health, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Faythe Miller
- Public Health, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Deepesh Khanna
- Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
| |
Collapse
|
3
|
Horowitz JD, Adeghate JO, Karani R, Henriquez DR, Gorroochurn P, Sharma T, Park L, Wang Q, Diamond DF, Harizman N, Auran JD, Maruri SC, Liebmann JM, Cioffi GA, Hark LA. Manhattan Vision Screening and Follow-Up Study: (NYC-SIGHT)Tele-Retinal Image Findings and Importance of Photography. Telemed J E Health 2024; 30:664-676. [PMID: 37651209 DOI: 10.1089/tmj.2023.0134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
Abstract
Purpose: To describe tele-retinal abnormality image findings from the Manhattan Vision Screening and Follow-up Study (NYC-SIGHT), which aims to investigate whether community-based eye health outreach strategies using telemedicine can improve visual outcomes among at-risk populations in Upper Manhattan. Methods: A 5-year prospective, cluster-randomized clinical trial was conducted. Eligible individuals aged 40 years and older were recruited from affordable housing developments and senior centers in New York City. Participants underwent on-site eye health screening (best-corrected visual acuity, intraocular pressure [IOP] measurements, and fundus photography). Fundus images were graded via telemedicine by a retina specialist. Multivariate logistic regression modeling was used to assess the factors associated with abnormal retinal findings requiring referral to ophthalmology. Results: Participants with a retinal abnormality on fundus photography (n = 157) were predominantly older adults, with a mean age of 68.4 ± 11.1 years, female (63.7%), African American (50.3%), and Hispanic (43.3%). A total of 32 participants in our study passed the vision and IOP screening but had an abnormal retinal image and ocular pathology that would have been missed without fundus photography. Individuals who self-identified as having preexisting glaucoma (odds ratio [OR] = 3.749, 95% confidence interval [CI] = 1.741-8.074, p = 0.0001) and had severe vision impairment (OR = 4.1034, 95% CI = 2.0740-8.1186, p = 0.000) at the screening had significantly higher odds of having an abnormal retinal image. Conclusion: This community-based study targeted populations at-risk for eye disease, improved access to eye care, detected a significant number of retinal image abnormalities requiring follow-up by using telemedicine, and provided evidence of the importance of fundus photography during eye health screenings. CTR number: NCT04271709.
Collapse
Affiliation(s)
- Jason D Horowitz
- Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
- Edward S. Harkness Eye Institute, Columbia University, Irving Medical Center, New York, New York, USA
| | - Jennifer O Adeghate
- Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
- Edward S. Harkness Eye Institute, Columbia University, Irving Medical Center, New York, New York, USA
| | - Rabia Karani
- Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
- Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Desiree R Henriquez
- Edward S. Harkness Eye Institute, Columbia University, Irving Medical Center, New York, New York, USA
| | - Prakash Gorroochurn
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Tarun Sharma
- Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
- Edward S. Harkness Eye Institute, Columbia University, Irving Medical Center, New York, New York, USA
| | - Lisa Park
- Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
- Edward S. Harkness Eye Institute, Columbia University, Irving Medical Center, New York, New York, USA
| | - Qing Wang
- Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
- Edward S. Harkness Eye Institute, Columbia University, Irving Medical Center, New York, New York, USA
| | - Daniel F Diamond
- Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
- Edward S. Harkness Eye Institute, Columbia University, Irving Medical Center, New York, New York, USA
| | - Noga Harizman
- Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
- Edward S. Harkness Eye Institute, Columbia University, Irving Medical Center, New York, New York, USA
| | - James D Auran
- Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
- Edward S. Harkness Eye Institute, Columbia University, Irving Medical Center, New York, New York, USA
| | - Stefania C Maruri
- Edward S. Harkness Eye Institute, Columbia University, Irving Medical Center, New York, New York, USA
| | - Jeffrey M Liebmann
- Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
- Edward S. Harkness Eye Institute, Columbia University, Irving Medical Center, New York, New York, USA
| | - George A Cioffi
- Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
- Edward S. Harkness Eye Institute, Columbia University, Irving Medical Center, New York, New York, USA
| | - Lisa A Hark
- Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
- Edward S. Harkness Eye Institute, Columbia University, Irving Medical Center, New York, New York, USA
| |
Collapse
|
4
|
Delavar A, Bu JJ, Radha Saseendrakumar B, Weinreb RN, Baxter SL. Gender Disparities in Depression, Stress, and Social Support Among Glaucoma Patients. Transl Vis Sci Technol 2023; 12:23. [PMID: 38149963 PMCID: PMC10755593 DOI: 10.1167/tvst.12.12.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 12/14/2023] [Indexed: 12/28/2023] Open
Abstract
Purpose To understand differences in measures of depression, stress, and social support by gender among those diagnosed with glaucoma. Methods We obtained a cohort of glaucoma patients (any type) ages 18 years and over who answered the COVID-19 Participant Experience (COPE) survey of the NIH All of Us Research Program. We analyzed several measures of depression, stress, and social support by gender. Logistic regression was used to evaluate the association among reported stress associated with social distancing, depression (using Patient Health Questionnaire-9 [PHQ-9] scores), and measures of social support by self-reported gender, with men as the reference group. Multivariable models were adjusted for age, race and ethnicity, health insurance status, education, and income. Results Of 3633 glaucoma patients, 56.8% were women. Many patients had a PHQ-9 score > 4 (33.3%), indicating mild, moderate, or severe depression. In multivariable models, women were significantly more likely to report a PHQ-9 score > 4 (odds ratio [OR] = 1.40; 95% confidence interval [CI], 1.20-1.62; P < 0.001) and some or a lot of stress (OR = 1.34; 95% CI, 1.14-1.57; P < 0.001) compared with men. Further, women were significantly less likely to report having help all or most of the time if they needed someone to prepare meals (OR = 0.78; 95% CI, 0.67-0.92; P = 0.002) or perform daily chores (OR = 0.79; 95% CI, 0.67-0.91; P = 0.003) than men. Conclusions Women with glaucoma were more likely to experience depression and stress and were less likely to have social support on some measures than men. Translational Relevance The disproportionate burden of psychosocial factors among women may complicate glaucoma management.
Collapse
Affiliation(s)
- Arash Delavar
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
- Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA, USA
- Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, TX, USA
| | - Jennifer J. Bu
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
| | - Bharanidharan Radha Saseendrakumar
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
- Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Robert N. Weinreb
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
- Hamilton Glaucoma Center, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
| | - Sally L. Baxter
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
- Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA, USA
- Hamilton Glaucoma Center, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
| |
Collapse
|
5
|
Wu G, Lee DA, Zhao W, Wong A, Sidhu S. ChatGPT: is it good for our glaucoma patients? FRONTIERS IN OPHTHALMOLOGY 2023; 3:1260415. [PMID: 38983063 PMCID: PMC11182305 DOI: 10.3389/fopht.2023.1260415] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 09/01/2023] [Indexed: 07/11/2024]
Abstract
Purpose Our study investigates ChatGPT and its ability to communicate with glaucoma patients. Methods We inputted eight glaucoma-related questions/topics found on the American Academy of Ophthalmology (AAO)'s website into ChatGPT. We used the Flesch-Kincaid test, Gunning Fog Index, SMOG Index, and Dale-Chall readability formula to evaluate the comprehensibility of its responses for patients. ChatGPT's answers were compared with those found on the AAO's website. Results ChatGPT's responses required reading comprehension of a higher grade level (average = grade 12.5 ± 1.6) than that of the text on the AAO's website (average = 9.4 grade ± 3.5), (0.0384). For the eight responses, the key ophthalmic terms appeared 34 out of 86 times in the ChatGPT responses vs. 86 out of 86 times in the text on the AAO's website. The term "eye doctor" appeared once in the ChatGPT text, but the formal term "ophthalmologist" did not appear. The term "ophthalmologist" appears 26 times on the AAO's website. The word counts of the answers produced by ChatGPT and those on the AAO's website were similar (p = 0.571), with phrases of a homogenous length. Conclusion ChatGPT trains on the texts, phrases, and algorithms inputted by software engineers. As ophthalmologists, through our websites and journals, we should consider encoding the phrase "see an ophthalmologist". Our medical assistants should sit with patients during their appointments to ensure that the text is accurate and that they fully comprehend its meaning. ChatGPT is effective for providing general information such as definitions or potential treatment options for glaucoma. However, ChatGPT has a tendency toward repetitive answers and, due to their elevated readability scores, these could be too difficult for a patient to read.
Collapse
Affiliation(s)
- Gloria Wu
- Department of Ophthalmology, University of California San Francisco, San Francisco, CA, United States
| | - David A Lee
- Department of Ophthalmology, McGovern Medical School, University of Texas Health Science Center, Houston, TX, United States
| | - Weichen Zhao
- Department of Biological Sciences, University of California Davis, Davis, CA, United States
| | - Adrial Wong
- Department of Biological Sciences, University of California Davis, Davis, CA, United States
| | - Sahej Sidhu
- Department of Biology, Santa Clara University, Santa Clara, CA, United States
| |
Collapse
|
6
|
Breeze F, Hossain RR, Mayo M, McKelvie J. Predicting ophthalmic clinic non-attendance using machine learning: Development and validation of models using nationwide data. Clin Exp Ophthalmol 2023; 51:764-774. [PMID: 37885379 DOI: 10.1111/ceo.14310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 09/04/2023] [Accepted: 10/08/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND Ophthalmic clinic non-attendance in New Zealand is associated with poorer health outcomes, marked inequities and costs NZD$30 million per annum. Initiatives to improve attendance typically involve expensive and ineffective brute-force strategies. The aim was to develop machine learning models to accurately predict ophthalmic clinic non-attendance. METHODS This multicentre, retrospective observational study developed and validated predictive models of clinic non-attendance. Attendance data for 3.1 million appointments from all New Zealand government-funded ophthalmology clinics from 2009 to 2018 were aggregated for analysis. Repeated ten-fold cross validation was used to train and optimise XGBoost and logistic regression models on several demographic and clinic-related variables. Models developed using the entire training set were compared with those restricted to regional subsets of the data. RESULTS In the testing data set from 2019, there were 407 574 appointments (median [range] age, 66 [0-105] years; 210 365 [51.6%] female) with a non-attendance rate of 5.7% (n = 23 309 missed appointments), XGBoost models trained on each region's data achieved the highest mean AUROC of 0.764 (SD 0.058) and mean AUPRC of 0.157 (SD 0.072). XGBoost performed better than logistic regression (mean AUROC = 0.756, p = 0.002). Training individual XGBoost models for each region led to better performance than training a single model on the complete nationwide dataset (mean AUROC = 0.754, p = 0.04). CONCLUSION Machine learning algorithms can predict ophthalmic clinic non-attendance with relatively basic demographic and clinic data. These findings suggest further research examining implementation of such algorithms in scheduling systems or public health interventions may be useful.
Collapse
Affiliation(s)
- Finley Breeze
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand
| | - Ruhella R Hossain
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand
- Department of Ophthalmology, Waikato Hospital, Hamilton, New Zealand
| | - Michael Mayo
- Department of Computer Science, University of Waikato, Hamilton, New Zealand
| | - James McKelvie
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand
- Department of Ophthalmology, Waikato Hospital, Hamilton, New Zealand
| |
Collapse
|
7
|
Davuluru SS, Jess AT, Kim JSB, Yoo K, Nguyen V, Xu BY. Identifying, Understanding, and Addressing Disparities in Glaucoma Care in the United States. Transl Vis Sci Technol 2023; 12:18. [PMID: 37889504 PMCID: PMC10617640 DOI: 10.1167/tvst.12.10.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 10/09/2023] [Indexed: 10/28/2023] Open
Abstract
Glaucoma is the leading cause of irreversible blindness worldwide, currently affecting around 80 million people. Glaucoma prevalence is rapidly rising in the United States due to an aging population. Despite recent advances in the diagnosis and treatment of glaucoma, significant disparities persist in disease detection, management, and outcomes among the diverse patient populations of the United States. Research on disparities is critical to identifying, understanding, and addressing societal and healthcare inequalities. Disparities research is especially important and impactful in the context of irreversible diseases such as glaucoma, where earlier detection and intervention are the primary approach to improving patient outcomes. In this article, we first review recent studies identifying disparities in glaucoma care that affect patient populations based on race, age, and gender. We then review studies elucidating and furthering our understanding of modifiable factors that contribute to these inequities, including socioeconomic status (particularly age and education), insurance product, and geographic region. Finally, we present work proposing potential strategies addressing disparities in glaucoma care, including teleophthalmology and artificial intelligence. We also discuss the presence of non-modifiable factors that contribute to differences in glaucoma burden and can confound the detection of glaucoma disparities. Translational Relevance By recognizing underlying causes and proposing potential solutions, healthcare providers, policymakers, and other stakeholders can work collaboratively to reduce the burden of glaucoma and improve visual health and clinical outcomes in vulnerable patient populations.
Collapse
Affiliation(s)
- Shaili S. Davuluru
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Alison T. Jess
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Kristy Yoo
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Van Nguyen
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Benjamin Y. Xu
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| |
Collapse
|
8
|
Kim AB, Cheng BT, Hwang BP. Delayed or Forgone Healthcare Due to COVID-19 among Adults with Vision Impairment. Ophthalmic Epidemiol 2023; 30:537-539. [PMID: 36691335 DOI: 10.1080/09286586.2022.2159985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 12/06/2022] [Accepted: 12/12/2022] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Decreased public transit, no‑visitor policies, and other restrictions to reduce the spread of COVID‑19 may limit healthcare access for vision impaired adults. This study aimed to assess rates of healthcare delayed or forgone due to COVID‑19 among adults with low vision. METHODS Data were analyzed from the 2021 National Health Interview Survey, a representative sample of US adults. Vision and hearing impairment were determined by self‑report. The primary study outcome was delayed or canceled medical care due to COVID‑19. Multivariable logistic regression models adjusted for gender, age, race, education, insurance, income, region, and chronic comorbidities were constructed to examine associations of medical care delayed due to COVID‑19. RESULTS Overall, 1.6% (n=457) of adults had vision impairment and 1.6% (n=438) had hearing impairment. Vision impairment was not associated with having taken a COVID‑19 test (P=0.34) or previous COVID‑19 infection (P=0.46). Adults with vs without low vision had higher rates of delayed (30.7% vs 19.2%, 1.86 [1.43-2.42], P<.0001) and cancelled care due to COVID-19 (23.9% vs 12.2%, 2.21 [1.66-2.94], P<.0001). Even compared to adults with hearing impairment, those with vision impairment were more likely to report canceled medical care due to COVID‑19 (1.20 [1.02-1.41], P=0.03). CONCLUSION Adults with low vision had increased risk of delayed and canceled medical care due to COVID‑19, with increased rates of canceled medical care even when compared to those with hearing impairment. These results suggest COVID‑19 and interventions to limit its spread have had a disproportionate impact on adults with low vision and place them at risk of poor health outcomes.
Collapse
Affiliation(s)
- Anne B Kim
- Rush University Medical College, Chicago, Illinois, USA
| | - Brian T Cheng
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Wills Eye Hospital at the Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Bryce P Hwang
- Wills Eye Hospital at the Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| |
Collapse
|
9
|
Andoh JE, Ezekwesili AC, Nwanyanwu K, Elam A. Disparities in Eye Care Access and Utilization: A Narrative Review. Annu Rev Vis Sci 2023; 9:15-37. [PMID: 37254050 DOI: 10.1146/annurev-vision-112122-020934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This narrative review summarizes the literature on factors related to eye care access and utilization in the United States. Using the Healthy People 2030 framework, this review investigates social determinants of health associated with general and follow-up engagement, screenings, diagnostic visits, treatment, technology, and teleophthalmology. We provide hypotheses for these documented eye care disparities, featuring qualitative, patient-centered research. Lastly, we provide recommendations in the hopes of appropriately eliminating these disparities and reimagining eye care.
Collapse
Affiliation(s)
- Joana E Andoh
- Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Agnes C Ezekwesili
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kristen Nwanyanwu
- Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, Connecticut, USA
| | - Angela Elam
- Department of Ophthalmology, WK Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, USA;
| |
Collapse
|
10
|
Paul ME, Tseng VL, Kitayama K, Yu F, Coleman AL. Evaluating Discrepancies in Self-Reported Glaucoma and Electronic Health Records in the National Institutes of Health All of Us Database. Ophthalmol Glaucoma 2023; 6:521-529. [PMID: 36931428 DOI: 10.1016/j.ogla.2023.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/17/2023] [Accepted: 03/07/2023] [Indexed: 03/17/2023]
Abstract
PURPOSE Patient understanding of glaucoma diagnosis is critical for disease management and it is unclear if there are racial/ethnic differences in this regard. The purpose of this study was to determine the level of agreement between glaucoma diagnosis by self-report and electronic health record (EHR) data using the National Institute of Health's "All of Us (AoU)" database and to examine the association between race/ethnicity and discordance of glaucoma diagnosis between self-report and EHR data. DESIGN Cross-sectional study. PARTICIPANTS Individuals in AoU who answered a survey question about glaucoma diagnosis and had EHR data availability. METHODS The agreement between self-reported glaucoma and EHR data was estimated using Cohen's κ coefficient. Multivariable logistic regression was performed, adjusting for age, sex, education level, income, and health care literacy, to examine the associations between race/ethnicity and discordance between self-reported glaucoma and EHR diagnosis. MAIN OUTCOME MEASURES Agreement between self-reported glaucoma and EHR diagnosis. RESULTS Of all 87 782 individuals, 1985 (2.26%) had both self-reported and EHR glaucoma, 81 781 (92.16%) had no glaucoma, 2022 (2.31%) individuals had EHR-only glaucoma, and 1994 (2.27%) had self-report-only glaucoma (Cohen's κ = 0.47). In the multivariable regression, Black or African American (adjusted odds ratio [aOR], 1.67; 95% confidence interval [CI], 1.40-1.98), Asian (aOR, 2.63; 95% CI, 1.97-3.44), and Hispanic or Latino (aOR, 1.63; 95% CI, 1.33-1.99) individuals were more likely to have EHR-only glaucoma than White individuals. Additionally, Black or African American (aOR, 2.30; 95% CI, 1.97-2.67) and Hispanic or Latino individuals (aOR,1.47; 95% CI, 1.21-1.79) were more likely to have self-report-only glaucoma compared with White individuals. CONCLUSIONS In the AoU database, we found that Black or African American and Hispanic or Latino individuals had higher odds of discordance between glaucoma diagnosis by self-report and EHR. Future studies are needed to examine the issues leading to this discordance, such as a lack of patient understanding regarding their diagnosis or a lack of culturally appropriate physician explanation/teaching. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Collapse
Affiliation(s)
- Megan E Paul
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Victoria L Tseng
- Department of Ophthalmology, Stein and Doheny Eye Institutes, University of California, Los Angeles, California
| | - Ken Kitayama
- Department of Ophthalmology, Stein and Doheny Eye Institutes, University of California, Los Angeles, California; Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California
| | - Fei Yu
- Department of Ophthalmology, Stein and Doheny Eye Institutes, University of California, Los Angeles, California; Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, California
| | - Anne L Coleman
- Department of Ophthalmology, Stein and Doheny Eye Institutes, University of California, Los Angeles, California; Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California.
| |
Collapse
|
11
|
Kim AB, Cheng BT, Tanna AP. Delayed Medical Care Due to Lack of Transportation among US Adults with Glaucoma. Ophthalmol Glaucoma 2023; 6:439-441. [PMID: 36990434 DOI: 10.1016/j.ogla.2023.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 02/16/2023] [Accepted: 03/15/2023] [Indexed: 03/29/2023]
Affiliation(s)
- Anne B Kim
- Rush University Medical College, Chicago, Illinois
| | - Brian T Cheng
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Angelo P Tanna
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
| |
Collapse
|
12
|
Zeng R, LaMattina KC. Follow-Up Adherence After Community Health Vision Screening Programs: A Review of the Literature. JOURNAL OF ACADEMIC OPHTHALMOLOGY (2017) 2023; 15:e223-e231. [PMID: 37795383 PMCID: PMC10547536 DOI: 10.1055/s-0043-1771354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 06/28/2023] [Indexed: 10/06/2023]
Abstract
Objective Although the purpose of community eye screening programs is to reduce health care disparities, the effectiveness of these programs is limited by the follow-up adherence of their participants. The aim of this review is to investigate factors that may promote or hinder participants from attending follow-up ophthalmological exams after community eye screenings and identify interventions to increase follow-up rates. Methods For literature review, PubMed, Web of Science, Embase, Proquest/Global Health Library, and Google Scholar databases were searched to identify studies of community eye screenings published between January 2000 and May 2023. Data from these articles were analyzed to identify barriers and facilitators of follow-up adherence after community eye screenings in the United States and to examine strategies used to increase follow-up rates. Only published manuscripts were included. We excluded studies of school screenings and clinic-based screenings. Results A total of 28 articles were included. Follow-up rates ranged from 12.5 to 89%. Nineteen articles reviewed facilitators and barriers to follow-up. Eighteen articles were non interventional and seven (see Table 1 and 2 , respectively) articles described interventions that were tested to improve follow-up rates after screening. Interventions included prescheduled appointments, transportation assistance, patient education, and patient navigators. Conclusion Several interventions are promising to increase follow-up adherence in community eye screenings, but more evidence is needed. Future research should focus on randomized trials of isolated interventions to improve follow-up adherence of disadvantaged populations, although this may be limited given ethical considerations and documented lack of follow-up after screening.
Collapse
Affiliation(s)
- Rebecca Zeng
- Department of Ophthalmology, Boston University School of Medicine, Boston, Massachusetts
| | - Kara C. LaMattina
- Department of Ophthalmology, Boston University School of Medicine, Boston, Massachusetts
- Department of Ophthalmology, Boston Medical Center, Boston, Massachusetts
| |
Collapse
|
13
|
Yuen J, Xu B, Song BJ, Daskivich LP, Rodman J, Wong BJ. Effectiveness of Glaucoma Screening and Factors Associated with Follow-up Adherence among Glaucoma Suspects in a Safety-Net Teleretinal Screening Program. Ophthalmol Glaucoma 2023; 6:247-254. [PMID: 36332907 DOI: 10.1016/j.ogla.2022.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 10/26/2022] [Accepted: 10/27/2022] [Indexed: 05/26/2023]
Abstract
PURPOSE To evaluate rates and risk factors associated with follow-up adherence to in-person glaucoma evaluations and confirmed glaucoma diagnosis in glaucoma suspects identified through teleretinal diabetic retinopathy screening (TDRS). DESIGN Retrospective cohort study SUBJECTS: Patients with diabetes identified through teleretinal screening to have large or asymmetric cup-to-disc ratios in a Los Angeles County safety-net primary care-based TDRS program. METHODS Retrospective chart review was performed to obtain demographic and clinical information for patients with cup-to-disc ratios concerning for glaucoma on TDRS. Patients who completed an in-person follow-up appointment within 1 year of teleretinal screening were adherent. Factors associated with follow-up adherence and diagnosis of glaucoma were analyzed with chi-square and independent t tests along with multivariable logistic regressions. MAIN OUTCOME MEASURES The proportion of patients with suspected glaucoma who adhered with in-person follow-up examination, proportion of patients with confirmed glaucoma diagnosis, and factors associated with follow-up adherence and glaucoma diagnosis. RESULTS Eight-hundred seventeen patients with optic discs suspicious for glaucoma were included. Five-hundred thirty-four (65.4%) patients successfully completed an in-person glaucoma evaluation. Among these patients, 62.9% and 24.5% received a diagnosis of glaucoma suspect and glaucomatous optic neuropathy, respectively. Compared with patients aged < 50 years, patients aged 50 to 64 years had 1.57 times higher odds of being adherent with in-person visits (P = 0.036), whereas no difference was seen in those aged ≥ 65 years. For every $10 000 increase in the zip code median income, patients had 11% lower odds of being adherent (P = 0.031). Compared with Latino patients, Black patients had 3.52 times (P < 0.001) higher odds of having confirmed glaucoma. CONCLUSION The majority of patients referred as glaucoma suspects on TDRS completed a follow-up examination, and nearly a quarter of those examined received a confirmed glaucoma diagnosis. Patients aged ≥ 50 and < 65 years along with those from lower-income neighborhoods were more likely to follow up for an in-person evaluation. Compared with Latino patients, Black patients had a higher risk for a confirmed glaucoma diagnosis. This demonstrates the effectiveness of glaucoma detection in a large-scale TDRS program for a safety-net patient population. FINANCIAL DISCLOSURE(S) The authors have no proprietary or commercial interest in any materials discussed in this article.
Collapse
Affiliation(s)
- Jenay Yuen
- Department of Ophthalmology, USC Roski Eye Institute, Keck School of Medicine of University of Southern California, Los Angeles, California
| | - Benjamin Xu
- Department of Ophthalmology, USC Roski Eye Institute, Keck School of Medicine of University of Southern California, Los Angeles, California
| | - Brian J Song
- Department of Ophthalmology, USC Roski Eye Institute, Keck School of Medicine of University of Southern California, Los Angeles, California
| | - Lauren P Daskivich
- Department of Ophthalmology, USC Roski Eye Institute, Keck School of Medicine of University of Southern California, Los Angeles, California; Department of Ophthalmology, LAC+USC Medical Center, Los Angeles, California
| | - John Rodman
- Southern California Clinical and Translational Science Institute, University of Southern California, Los Angeles, California
| | - Brandon J Wong
- Department of Ophthalmology, USC Roski Eye Institute, Keck School of Medicine of University of Southern California, Los Angeles, California; Department of Ophthalmology, LAC+USC Medical Center, Los Angeles, California.
| |
Collapse
|
14
|
Delavar A, Bu JJ, Radha Saseendrakumar B, Weinreb RN, Baxter SL. Mental health and social support among glaucoma patients enrolled in the NIH All of Us COVID-19 Participant Experience (COPE) survey. BMC Ophthalmol 2023; 23:63. [PMID: 36782129 PMCID: PMC9923653 DOI: 10.1186/s12886-023-02771-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 01/04/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic created many challenges for our society. In this study, we explore how measures of mental health, coping strategies, and social support during the pandemic varied by glaucoma status. METHODS A cohort of patients aged 40 and over enrolled in the NIH All of Us Research Program, a nationwide longitudinal cohort, who answered the COVID-19 Participant Experience (COPE) survey was obtained. We analyzed several measures of mental health, coping strategies, and social support used during the early stages of the COVID-19 pandemic. Surveys were recurring and answered from May 2020 to February 2021. Demographics and the most recently answered survey responses were obtained and stratified by glaucoma status. Pearson's Chi-squared tests and multivariable logistic regressions adjusting for age, gender, race, ethnicity, and income were used to generate p-values, odds ratios (ORs) and 95% confidence intervals (CIs) between outcome measures and glaucoma status. RESULTS Of 42,484 patients who responded to All of Us COPE survey items, 2912 (6.9%) had a diagnosis of glaucoma. On Pearson's Chi-squared tests glaucoma patients were less likely to report drinking alcohol (P = 0.003), eating more food than usual (P = 0.004), and using marijuana (P = 0.006) to cope with social distancing than those without a diagnosis of glaucoma. Further, glaucoma patients had lower rates of probable mild, moderate, or severe depression as calculated by Patient Health Questionnaire-9 (PHQ-9) scores (P < 0.001) and had lower rates of reporting some or a lot of stress from social distancing (P < 0.001). However, glaucoma patients were less likely to report having someone to help prepare meals (P = 0.005) or help with daily chores (P = 0.003) if they became sick with COVID-19. In multivariable logistic regression analyses adjusting for confounding factors, no differences were found for measures of mental health or social support. CONCLUSIONS Glaucoma patients did not fare worse on many measures of mental health and coping strategies during the early stages of the COVID-19 pandemic compared those without glaucoma. However, a substantial proportion of glaucoma patients still endorsed stress, social isolation, and probable depression, representing challenges for disease management.
Collapse
Affiliation(s)
- Arash Delavar
- grid.266100.30000 0001 2107 4242Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA USA ,grid.266100.30000 0001 2107 4242Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive MC 0946, La Jolla, CA 92093 USA
| | - Jennifer J. Bu
- grid.266100.30000 0001 2107 4242Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive MC 0946, La Jolla, CA 92093 USA
| | - Bharanidharan Radha Saseendrakumar
- grid.266100.30000 0001 2107 4242Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA USA ,grid.266100.30000 0001 2107 4242Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive MC 0946, La Jolla, CA 92093 USA
| | - Robert N. Weinreb
- grid.266100.30000 0001 2107 4242Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA USA
| | - Sally L. Baxter
- grid.266100.30000 0001 2107 4242Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA USA ,grid.266100.30000 0001 2107 4242Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive MC 0946, La Jolla, CA 92093 USA
| |
Collapse
|
15
|
Elam AR, Tseng VL, Rodriguez TM, Mike EV, Warren AK, Coleman AL. Disparities in Vision Health and Eye Care. Ophthalmology 2022; 129:e89-e113. [PMID: 36058735 PMCID: PMC10109525 DOI: 10.1016/j.ophtha.2022.07.010] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/11/2022] [Accepted: 07/14/2022] [Indexed: 10/14/2022] Open
Abstract
Significant disparities in vision health and eye care exist. To achieve health equity, we must understand the root causes and drivers of health disparities and inequities, including social determinants of health and systemic racism.
Collapse
Affiliation(s)
- Angela R Elam
- Department of Ophthalmology and Visual Sciences, W. K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan; Center for Eye Policy and Innovation, University of Michigan, Ann Arbor, Michigan.
| | - Victoria L Tseng
- UCLA Stein and Doheny Eye Institutes, David Geffen School of Medicine, University of California, Los Angeles, California
| | | | - Elise V Mike
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Alexis K Warren
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois
| | - Anne L Coleman
- UCLA Stein and Doheny Eye Institutes, David Geffen School of Medicine, University of California, Los Angeles, California; Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California
| |
Collapse
|
16
|
Williams AM, Schempf T, Liu PJ, Rosdahl JA. Loss to Follow up among Glaucoma Patients at a Tertiary Eye Center over 10 Years: Incidence, Risk Factors, and Clinical Outcomes. Ophthalmic Epidemiol 2022:1-9. [PMID: 36154557 DOI: 10.1080/09286586.2022.2127787] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
PURPOSE To assess the incidence, risk factors, and clinical consequences of loss to follow up (LTFU) among glaucoma patients at our institution over a 10-year period. METHODS This retrospective study examined LTFU among a cohort of glaucoma patients with a clinical encounter in 2010. LTFU was defined as 52 weeks or more without an encounter and without alternative reason for discontinued care, such as discharge, documented move, or death. Baseline demographic and clinical characteristics were collected and compared between LTFU and non-LTFU groups using a logistic regression model to identify risk factors for LTFU. Odds ratios (ORs) are reported with 95% confidence intervals. Clinical outcomes were documented for LTFU patients who returned after a lapse in care. RESULTS Among the 395 included patients, 132 (33%) were LTFU over the 10-year study period. Characteristics associated with LTFU in a logistic regression model included greater disease severity (OR = 1.03 [1.01-1.05], p = .023, for each worsening decibel of mean deviation) and in-state rather than out-of-state residence (OR = 2.76 [1.12-6.80], p = .027). Other potential risk factors that did not reach significance included male gender (OR = 1.39 [0.92-2.13], p = .124), Black race (OR = 1.40 [0.91-2.16] p = .123), and legal blindness (OR = 1.58 [0.91-2.76] p = .107). Among the 132 patients who were LTFU, only 23 (17%) later returned to care, two-thirds (15/23) of whom returned with disease progression or complication. CONCLUSION One-third of glaucoma patients became LTFU over a 10-year period, and LTFU may be associated with poor clinical outcomes. More research is needed to understand reasons for LTFU and to promote regular glaucoma care.
Collapse
Affiliation(s)
- Andrew M Williams
- Department of Ophthalmology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.,Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina, USA
| | - Tadhg Schempf
- Department of Ophthalmology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Peggy J Liu
- Department of Business Administration, Marketing and Business Economics Area, Joseph M. Katz Graduate School of Business, Pittsburgh, Pennsylvania, USA
| | - Jullia A Rosdahl
- Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina, USA
| |
Collapse
|
17
|
Evaluating Well-being of Individuals With Chronic Visual Conditions Requiring Regular Eyecare During COVID-19 Lockdown: A Cross-Sectional Study. Eye Contact Lens 2021; 47:559-564. [PMID: 34542424 DOI: 10.1097/icl.0000000000000834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To assess health-related quality of life (HRQoL) and its predictors among individuals with chronic vision conditions during COVID-19 lockdown. METHODS A cross-sectional, survey-based study targeted Jordanian adults with a variety of chronic vision conditions requiring regular ophthalmic follow-up. Outcome measures included HRQoL measured by the 12-item Short-Form Health Survey (SF-12), mental health symptoms measured by the Depression Anxiety Stress Scale, and vision ability measured by the National Eye Institute Visual Functioning Questionnaire (VFQ-25) General Vision and Role Limitation subscales. Data were analyzed descriptively and using a multiple variable linear regression model to identify HRQoL predictors. RESULTS A total of 203 participants with a mean age of 52.09 (±15.41) years participated, and SF-12 mean scores were 58.15 for the physical component and 57.48 for the mental component. The level of HRQoL was significantly associated with VFQ-25 Role Limitation subscale, diabetes, the need of ophthalmic follow-up, and stress. The regression model explained 47.1% of the variance in HRQoL (r2=0.471, F=35.57, P<0.001). CONCLUSIONS Jordanian individuals with chronic vision conditions demonstrated low levels of HRQoL during COVID-19 lockdown. Participants also showed high levels of mental health symptoms and reported low accessibility to ophthalmic care. Access to nonurgent ophthalmic care in individuals with chronic vision diseases should be carefully planned in future pandemics.
Collapse
|
18
|
Lessons Learned from Two Large Community-Based Glaucoma Screening Studies. J Glaucoma 2021; 30:875-877. [PMID: 34334703 DOI: 10.1097/ijg.0000000000001920] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 07/17/2021] [Indexed: 10/20/2022]
Abstract
Community-based screening programs have had limited success in preventing vision loss from glaucoma due to overall low prevalence of glaucoma, screening limitations, and barriers to follow-up appointments. This editorial highlights lessons learned from two large prospective trials: the Philadelphia Telemedicine Glaucoma Detection and Follow-up Study (PTGDFS) and the Screening To Prevent Glaucoma Study (SToPGS). While some lessons are specific to ophthalmology, many lessons are applicable to screening for asymptomatic diseases in underserved, vulnerable communities.
Collapse
|
19
|
Atta S, Omar M, Kaleem SZ, Waxman EL. The Use of Mobile Messaging for Telecommunications with Patients in Ophthalmology: A Systematic Review. Telemed J E Health 2021; 28:125-137. [PMID: 33794125 DOI: 10.1089/tmj.2020.0568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background: Communication and concordance between patients and providers are crucial for improved outcomes and disease prevention. Mobile health strategies have been shown to improve patient accessibility and convenience. Mobile messaging is one strategy that has demonstrated varying degrees of effectiveness in patient care. The aim of this review is to investigate methods, outcomes, and conclusions of studies that have assessed mobile messaging interventions in ophthalmology. Methods: A qualitative systematic review of PubMed, Scopus, Web of Science, and Embase databases was conducted to identify studies that investigated the implementation and efficacy of mobile messaging services in ophthalmology practice. Included articles were categorized based on study content: appointment attendance, patient preference and willingness, education, concordance, and other clinical outcomes. Three tools were used to assess for potential bias. Results: Out of a total of 3,655 unique titles retrieved, 15 articles were included in the final qualitative synthesis after abstract and full-text screening. Included studies were published between 2008 and 2020 from seven different countries and across various contexts. All but one study found that the use of mobile messaging in ophthalmology care led to improved process measures or patient outcomes. Evidence for a positive effect was the strongest for appointment follow-up. Survey and feedback data suggest that patients, more so younger patients, are open to mobile message interventions. Conclusion: Mobile messaging interventions can play a role in improving appointment attendance, patient education, and patient practices for ophthalmology patients. Further study is necessary to determine the effectiveness of this tool across various groups and settings.
Collapse
Affiliation(s)
- Sarah Atta
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Mahmoud Omar
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Syed Z Kaleem
- Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Evan L Waxman
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| |
Collapse
|