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Predictors of attendance to follow-up ophthalmic care

03 Feb 2018

Factors such as obesity, short distance between screening sites and hospital, poor presenting visual acuity (VA) in the better eye, and an abnormal macula on fundus photography are all associated with a higher rate of attendance to follow-up ophthalmic care, according to data from the SToP Glaucoma Study.

The ongoing study, which is aimed at developing an eye screening paradigm and increasing follow-up attendance rates, focused on African Americans aged ≥50 years. The total number of referred patients presenting for a free eye exam (attendance rate) overall was 885 (57.0 percent), including 686 (55.0 percent) during the first phase and 199 (63.8 percent) during the second phase.

In fully adjusted multivariable logistic regression models, attendance to the follow-up visit was associated with the following: screening in second vs first phase (odds ratio [OR], 1.82; 95 percent CI, 1.19–2.79), screening sites that were 3 to <5 miles vs <1 mile from the hospital (OR, 0.62; 0.39–0.99), BMI ≥30 vs <25 kg/m2 (OR, 1.70; 1.12–2.59), presentation of VA <20/40 vs ≥20/40 (OR, 2.03; 1.28–3.21), and an abnormal vs normal macula (OR, 2.32; 1.24–4.34).

Previous studies have consistently reported poor attendance to follow-up ophthalmic care, and some of the barriers associated with poor attendance included having less understanding of the mechanism and trajectory of one's eye disease, patient or escort difficulty getting time off work for appointments, and legal blindness. [Invest Ophthalmol Vis Sci 2015;56:4324-4331]

Chronic degenerative diseases such as AMD, diabetic retinopathy and glaucoma (GL) require regular follow-up appointments to optimally monitor a patient's course and adjust therapy. Commonly reported patient- and system-level factors that impede timely follow-up include advanced age, distance from clinic and transportation. [Am J Health Syst Pharm 2007;64:S8-S14; Arch Ophthalmol 2003;121:1303-1310; Am J Otolaryngol 2015;36:441-444; J Community Health 2013;38:976-993]

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