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Wu JH, Varkhedi V, Saseendrakumar BR, Acuff K, Weinreb RN, Baxter SL. Social and Health Care Utilization Factors Associated With Ophthalmic Visit Nonadherence in Glaucoma: An All of Us Study. J Glaucoma 2023; 32:1029-1037. [PMID: 37671531 PMCID: PMC10840877 DOI: 10.1097/ijg.0000000000002300] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 08/09/2023] [Indexed: 09/07/2023]
Abstract
PRCIS In a diverse nationwide cohort, lower education and income levels, cost saving on medications, fewer past-year medical/specialist visits, and concerns regarding dissimilarity with health care providers were risk factors for ophthalmic visit nonadherence among glaucoma patients. PURPOSE The purpose of this study was to characterize social and health care utilization factors associated with nonadherence with ophthalmic visits among patients with glaucoma. MATERIALS AND METHODS Glaucoma patients in the All of Us database who completed the Healthcare Access and Utilization Survey were included and categorized into "visit" and "nonvisit" groups based on visit adherence, defined by self-reported past-year encounters with eyecare providers (yes/no). Data regarding potential factors affecting ophthalmic visit adherence, including past-year medical visits, inabilities to afford health care, and self-reported reasons for delayed care, were extracted. χ 2 tests and logistic regression were used to compare the 2 groups. Odds ratios (ORs) of visit adherence were analyzed for potential risk factors. RESULTS Of 5739 glaucoma patients, 861 (15%) were in the nonvisit group. More participants in the visit group reported past-year general doctor/specialist visits (94%/65%; vs. nonvisit group: 89%/49.3%; P <0.05). The nonvisit group reported greater difficulty in affording medical care and learning about medical conditions, and higher rates of delayed/missed health care access for various concerns ( P <0.05). Older age (OR=1.02, 1.01-1.03), higher education (OR=1.25, 1.13-1.40), and income level (OR=1.06, 1.01-1.11), not employed for wages (OR=1.28, 1.08-1.53), and higher health care utilization in general medical/specialist visits (ORs range:1.08-1.90) were associated with visit adherence ( P <0.05). Visit nonadherence was associated with cost saving on medication (OR=0.62, 0.40-0.97) and delaying/avoiding seeing health care providers because of dissimilarity (OR=0.84, 0.71-0.99) ( P <0.05). CONCLUSIONS This study builds on prior literature by identifying potentially modifiable factors associated with visit nonadherence and underutilization of eyecare in glaucoma. These may inform strategies to improve real-world ophthalmic visit adherence and identify patients who might benefit from additional support.
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Affiliation(s)
- Jo-Hsuan Wu
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California
- Health Department of Biomedical Informatics, University of California San Diego, La Jolla, California
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, United States
| | - Varsha Varkhedi
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California
- Health Department of Biomedical Informatics, University of California San Diego, La Jolla, California
| | - 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, California
- Health Department of Biomedical Informatics, University of California San Diego, La Jolla, California
| | - Kaela Acuff
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California
- Health Department of Biomedical Informatics, University of California San Diego, La Jolla, California
| | - 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, California
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, United States
| | - 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, California
- Health Department of Biomedical Informatics, University of California San Diego, La Jolla, California
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, United States
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Rivera PA, Atayde A, Wang L, Kombo N. Female Authorship and Ophthalmology Journal Editorial Board Membership Trends Over the Last Decade, 2012-2021. Am J Ophthalmol 2023; 255:107-114. [PMID: 37463630 DOI: 10.1016/j.ajo.2023.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 07/01/2023] [Accepted: 07/01/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE To study the relationship between female authorship and editorial board membership in 3 ophthalmology journals from 2012 to 2021. DESIGN Cross-sectional and trend study. METHODS The prevalence of female first, senior authorship, and editorial board members were examined in Ophthalmology, JAMA Ophthalmology, and American Journal of Ophthalmology. Gender-API assigned gender to authors based on name and country. Editorial board (EB) information was manually extracted and grouped for comparison among leadership positions. Gender data collected on authorship and EB membership were compared. The proportion of women in EB positions was identified: editor-in-chief, mid-level editors, and consulting editors. Relationship between female authorship and editorial board membership was analyzed. RESULTS Women published fewer articles as first (1547/4267) and senior (1165/4267) authors than did men. The proportion of women in senior authorship significantly increased from 2012 to 2021 (23.4% to 30.5%, P = .0046). Across EB, a significant increase in female members (13.9% to 34.6%, P = .0006) was observed. There was a significant correlation (P < .0001) between female EB members and female authors (r = 0.74, 95% CI = 0.51-0.87) for all journals. The odds of female first authorships were 1.89 (95% CI = 1.65-2.17) times higher for articles with female senior authors than for male senior authors (P < .0001). CONCLUSION Female senior authorship significantly increased over the last decade. Journals with a higher representation of female EB members also had a higher representation of female authorship. This study found a positive association between first and senior female authorship; however, the gender gap persists. Continued efforts to reach equity in publications and EB representation are necessary.
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Affiliation(s)
- Paola A Rivera
- From the Department of Ophthalmology and Visual Science, Yale School of Medicine (P.A.R., N.K.), New Haven, Connecticut, USA
| | - Agata Atayde
- Harvard T.H. Chan School of Public Health (A.A.), Boston, Massachusetts, USA
| | - Lei Wang
- Harvey Cushing/John Hay Whitney Medical Library (L.W.), Yale University School of Medicine, New Haven, Connecticut, USA
| | - Ninani Kombo
- From the Department of Ophthalmology and Visual Science, Yale School of Medicine (P.A.R., N.K.), New Haven, Connecticut, USA.
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Afzali K, Fujimoto DK, Mohammadi SO, Lin KY. Race and Gender Shift among Academic Glaucoma Specialists in the Last 5 Decades. J Curr Glaucoma Pract 2023; 17:98-103. [PMID: 37485463 PMCID: PMC10357023 DOI: 10.5005/jp-journals-10078-1407] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 06/03/2023] [Indexed: 07/25/2023] Open
Abstract
Purpose To evaluate the demographic composition of academic glaucoma specialists currently practicing in the United States. Design Retrospective and observational study. Subjects Academic glaucoma specialists identified from ophthalmology residency programs listed on the Doximity database. Methods The American Board of Ophthalmology (ABO) membership directory, Doximity database, publicly available data, and direct communications were used to identify academic glaucoma specialists and their demographics. Information collected included-name, gender, race/ethnicity, geographic location, board certification date, academic affiliation, and academic rank. Ophthalmic age was defined as the number of years since ophthalmology board certification. Underrepresented minority (URM) groups were defined as Hispanics, Black or African Americans, Latinos, American Indians, or Alaskan Natives as defined by San Francisco match. In addition, the temporal, geographic, and academic rank distributions among females and URMs were explored. Main outcome measures Women and URMs representations among academic glaucoma specialists across academic ranks, geographic regions, as well as ophthalmic age. Results There were 457 active academic glaucoma specialists identified from 110 institutions in 38 states. Among them, 185 (40.5%) were women and 42 (9.2%) were URM. The proportion of women glaucoma specialists in academia had increased significantly with a rate of 1.049 in odds ratio (OR) per year (p < 0.001). However, there were no significant changes in the proportion of URMs over time. The earliest year of certification was 1,964 for males and 1,974 for females. When controlled for ophthalmic age, there were no significant differences in the distribution of women or URMs between the different academic ranks (p = 0.572 and p = 0.762, respectively). Among assistant professors, women had a significantly higher ophthalmic age compared to men (p < 0.001), but there was no significant difference in ophthalmic age in both the associate and full professor groups. There were no significant differences in the geographic distribution of gender (p = 0.516) and URM across United States regions (p = 0.238). Conclusion The proportion of women among academic glaucoma specialists has significantly increased over the past 5 decades; however, the proportion of URMs has been stagnant in the same period. Enhancing URM representation among academic glaucoma specialists deserves to be a future priority. How to cite this article Afzali K, Fujimoto DK, Mohammadi SO, et al. Race and Gender Shift among Academic Glaucoma Specialists in the Last 5 Decades. J Curr Glaucoma Pract 2023;17(2):98-103.
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Affiliation(s)
- Kasra Afzali
- Department of Ophthalmology, Gavin Herbert Eye Institute, University of California, Irvine, California, United States
| | - Dylann K Fujimoto
- Department of Ophthalmology, Gavin Herbert Eye Institute, University of California, Irvine, California, United States
| | - Seyed Omid Mohammadi
- Department of Ophthalmology, Gavin Herbert Eye Institute, University of California, Irvine, California, United States
| | - Ken Y Lin
- Department of Ophthalmology, Gavin Herbert Eye Institute, University of California, Irvine, California, United States
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Erdem B, Obut A, Kay M, Gok M, Bostan S. Evaluating scientific research barriers by gender and other characteristics from the perspective of ophthalmologists in Turkey: A multicenter survey study. PLoS One 2023; 18:e0273181. [PMID: 36696420 PMCID: PMC9876363 DOI: 10.1371/journal.pone.0273181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 08/03/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND/AIM The ever-increasing population and life expectancy worldwide increase the prevalence of ophthalmic diseases, and the need for ophthalmic research expands accordingly. In our study, we aimed to evaluate many aspects of the barriers, especially gender disparities, confronting ophthalmologists who aspire to conduct scientific research (SR). MATERIALS AND METHODS In this descriptive quantitative study, we distributed an online questionnaire to ophthalmologists in Turkey with 21 questions presented on a five-point Likert scale and two open-ended questions. The survey was prepared with Google forms. Participants were recruited via e-mail and social networks. A multicenter survey was conducted between January 29 and February 20, 2021, and a total of 210 valid responses were recorded. RESULTS Participants' responses were grouped into four types of barriers: motivation, time constraints, research support, and competence. Participants' motivation to conduct research was above average (3.54±0.96), but most stated that they have time constraints (3.74±0.97). Participants did not agree that there is adequate support for research (2.35±0.76), and they self assessed their level of the required competence to be average (2.87±1.08). Women were more motivated to do SR than men (p = 0.008), but there were no statistically significant differences between women and men in terms of time constraints, research support, and level of competence (p = 0.853, p = 0.482, and p = 0.558, respectively). Although there is no statistically significant difference between men and women regarding time constraints, female physicians mentioned more about the barriers arising from their personal responsibilities (p = 0.038). CONCLUSIONS Our study revealed that ophthalmologists are enthusiastic about doing SR but encounter obstacles with regard to time availability and research support. In addition, there is a need to reinforce competence in SR. Although female physicians are more motivated than men, they must deal with competing domestic responsibilities.
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Affiliation(s)
- Burak Erdem
- Department of Ophthalmology, Ordu University Faculty of Medicine, Ordu, Turkey
- * E-mail:
| | - Abdulkadir Obut
- Department of Ophthalmology, Afyon State Hospital, Afyon, Turkey
| | - Mehmet Kay
- Department of Ophthalmology, Sancaktepe Sehit Prof Dr Ilhan Varank Training and Research Hospital, Istanbul, Turkey
| | - Mustafa Gok
- Department of Ophthalmology, Private Atanur Eye Hospital, Isparta, Turkey
| | - Sedat Bostan
- Department of Health Management, Ordu University Faculty of Health Sciences, Ordu, Turkey
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Kurian M. Comment on: Women in ophthalmology- An upsurge! Indian J Ophthalmol 2022; 70:2202. [PMID: 35648020 PMCID: PMC9359270 DOI: 10.4103/ijo.ijo_605_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Merina Kurian
- Royal Wolverhampton NHS Trust, Wolverhampton Road, Heath Town, Wolverhampton WV10 0QP, United Kingdom
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Laroche D, Scheive M. How to Stop People from Going Blind from Glaucoma Using Early Cataract Surgery/Refractive Lensectomy and Microinvasive Glaucoma Surgery. Clin Ophthalmol 2022; 16:815-821. [PMID: 35313477 PMCID: PMC8934161 DOI: 10.2147/opth.s354338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/14/2022] [Indexed: 11/23/2022] Open
Abstract
Glaucoma continues to be a leading cause of blindness worldwide for the same reasons as in the past several decades, including the lack of early detection, improper treatment, and non-adherence to therapy. Medical therapy continues to be the first-line therapy even as surgical techniques are improving in their safety and efficacy. To turn the tide in preventing blindness from glaucoma, attention must be focused on targeted patient education, screening, effective treatment, and addressing health disparities. To achieve this, early safer cataract surgery and microinvasive glaucoma surgery must be considered as a first-line therapy in addition to medical therapy to best lower both intraocular pressure and the medication burden.
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Affiliation(s)
- Daniel Laroche
- Department of Ophthalmology, New York Eye and Ear Infirmary, Icahn School of Medicine of Mount Sinai, New York, NY, USA
- Advanced Eyecare of New York, New York, NY, USA
| | - Melanie Scheive
- Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN, USA
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Hamm LM, Yashadhana A, Burn H, Black J, Grey C, Harwood M, Peiris-John R, Burton MJ, Evans JR, Ramke J. Interventions to promote access to eyecare for non-dominant ethnic groups in high-income countries: a scoping review. BMJ Glob Health 2021; 6:e006188. [PMID: 34493531 PMCID: PMC8424858 DOI: 10.1136/bmjgh-2021-006188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 08/11/2021] [Indexed: 12/18/2022] Open
Abstract
PURPOSE People who are distinct from the dominant ethnic group within a country can experience a variety of barriers to accessing eyecare services. We conducted a scoping review to map published interventions aimed at improving access to eyecare for non-Indigenous, non-dominant ethnic groups residing in high-income countries. METHODS We searched MEDLINE, Embase and Global Health for studies that described an intervention to promote access to eyecare for the target population. Two authors independently screened titles and abstracts followed by review of the full text of potentially relevant sources. For included studies, data extraction was carried out independently by two authors. Findings were summarised using a combination of descriptive statistics and thematic analysis. RESULTS We screened 5220 titles/abstracts, of which 82 reports describing 67 studies met the inclusion criteria. Most studies were conducted in the USA (90%), attempted to improve access for Black (48%) or Latinx (28%) communities at-risk for diabetic retinopathy (42%) and glaucoma (18%). Only 30% included the target population in the design of the intervention; those that did tended to be larger, collaborative initiatives, which addressed both patient and provider components of access. Forty-eight studies (72%) evaluated whether an intervention changed an outcome measure. Among these, attendance at a follow-up eye examination after screening was the most common (n=20/48, 42%), and directly supporting patients to overcome barriers to attendance was reported as the most effective approach. Building relationships between patients and providers, running coordinated, longitudinal initiatives and supporting reduction of root causes for inequity (education and economic) were key themes highlighted for success. CONCLUSION Although research evaluating interventions for non-dominant, non-Indigenous ethnic groups exist, key gaps remain. In particular, the paucity of relevant studies outside the USA needs to be addressed, and target communities need to be involved in the design and implementation of interventions more frequently.
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Affiliation(s)
- Lisa M Hamm
- School of Optometry & Vision Science, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Aryati Yashadhana
- Centre for Health Equity Training Research & Evaluation, University of New South Wales, Sydney, New South Wales, Australia
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
- School of Social Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Helen Burn
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Joanna Black
- School of Optometry & Vision Science, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Corina Grey
- School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
- Performance Improvement, Auckland District Health Board, Auckland, New Zealand
| | - Matire Harwood
- School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Roshini Peiris-John
- School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Matthew J Burton
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
- Moorfields Eye Hospital, London, UK
| | - Jennifer R Evans
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Jacqueline Ramke
- School of Optometry & Vision Science, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
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Lin JC, Janigian NG, Kang C, Greenberg PB. Gender and country of residence of presenters in the retinal field at global ophthalmology conferences. Clin Exp Ophthalmol 2021; 49:768-770. [PMID: 34418256 DOI: 10.1111/ceo.13986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 08/16/2021] [Accepted: 08/16/2021] [Indexed: 11/30/2022]
Affiliation(s)
- John C Lin
- Program in Liberal Medical Education, Brown University, Providence, Rhode Island, USA.,Division of Ophthalmology, Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Nicholas G Janigian
- Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA
| | - Chaerim Kang
- Program in Liberal Medical Education, Brown University, Providence, Rhode Island, USA.,Division of Ophthalmology, Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Paul B Greenberg
- Division of Ophthalmology, Alpert Medical School, Brown University, Providence, Rhode Island, USA.,Section of Ophthalmology, Providence VA Medical Center, Providence, Rhode Island, USA
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Ramke J, Logan NS. Seeing beyond 2020: what next for refractive error care? Ophthalmic Physiol Opt 2021; 41:457-460. [PMID: 33826167 DOI: 10.1111/opo.12820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Jacqueline Ramke
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand.,International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
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