Patient survey explores attitudes on alternative glaucoma care model

Baltimore-Projections on ophthalmology workforce size in the future-as well as growth in patient demand for services-indicates a clear need for more efficient delivery of glaucoma care. Going on the assumption that a tele-ophthalmological approach offers a possible solution, researchers at Johns Hopkins University, Baltimore, undertook a survey to gauge patient acceptance.

In the alternative-care model, patients underwent their usual battery of diagnostic testing at a convenient location. Decisions about scheduling patient visits with the ophthalmologist were based on the clinician’s remote review of the test results.

Fifty-nine adult patients with glaucoma were included in the survey that was designed to capture perceptions on current care delivery and the proposed model. The results showed that 91% of the surveyed patients were satisfied with the existing frequency of their clinic visits, and that a slight majority (58%) would be in favor of the new model.

“We have the need for an alternative care model and the technology to carry out the tele-ophthalmological approach,” said Ravi Pandit, MPH, a fourth year medical student, Dana Center for Preventive Ophthalmology Wilmer Eye Hospital, Baltimore. “However, implementation will be a challenge if we are unable to engage patient cooperation.”

Analyses of the data collected showed no differences in mean age or distance traveled to the clinic when comparing patients favoring the new model and those opposed to it.

Factors that did appear to drive acceptance included the number of clinic visits per year (the odds of acceptance decreased with each additional visit) and whether patients believed the model would result in convenience advantages (shorter wait times for testing and avoiding unnecessary visits were associated with increased acceptance).

The findings from the survey, mr. Pandit said, provide useful information for planning a pilot investigation of the alternative care model. He noted that the inverse association between visit frequency and patient acceptance indicates that reassurance will be critical to patient acceptance.

“Patients who have more visits are probably the sickest and the ones who would benefit most from the alternative-care model as they would get more time with their ophthalmologist,” he said. “This information needs to be communicated to these patients.

“Then, if we transition into this model, we must ensure that the vulnerable segments of the patient population are not negatively affected,” he concluded.

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