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T. F. Ali, D. McCall, J. C. DuPont, C. O. Okeke; Effect of Knowledge and Trust on Follow-Up in Glaucoma Suspects. Invest. Ophthalmol. Vis. Sci. 2009;50(13):2470.
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To describe knowledge, attitudes and beliefs about glaucoma suspects, identified at community based glaucoma screenings, who do or do not follow-up.
This retrospective cohort study includes 50 randomly selected patients throughout the country identified as glaucoma suspects at community eye screenings sponsored by the Friends of the Congressional Glaucoma Caucus Foundation. The subject population was screened within 6 to 18 months of contact and included 32 females, 34 African Americans, 9 Caucasians, 1 Asian and 6 "other" for race. Subjects were asked to complete a mailed survey assessing their awareness of glaucoma, level of trust in the healthcare system, and whether they did or did not follow-up with an ophthalmologist after the screening. A monetary incentive for completing the survey was included in the mailing.
To date, questionnaires were completed and returned for 15.9% of eligible subjects. Responding subjects did not differ significantly from non-respondents with regard to age, gender, and ethnicity. A total of 12% of questionnaires were unopened returned to sender. Of the responding subjects, 71.4% were females and 71.4% were African Americans with a mean + SD age of 64.0 + 18.2 years. Only 57.1% recalled being told to see an eye doctor to evaluate for glaucoma and of those 75% went to see an eye doctor. Among respondents, 85.7% knew that glaucoma is a serious blinding disease, but 71.4% did not know that glaucoma runs in families. The mean distrust in the healthcare system scale score was 33 out of 45. Of the 28.5% of respondents reporting significant distrust, all were African-American, and 50% chose not to follow-up.
To date, nearly 45% of glaucoma suspect respondents found at community screenings do not recall being told to follow-up, but when they do recall, most make appointments. Most respondents were aware that glaucoma leads to blindness, though only 29% of subjects knew that glaucoma runs in families. Additionally, distrust appears to have some effect on follow-up. Efforts need to be made to improve understanding of glaucoma to suspects and to relay the importance of follow-up during screenings to improve compliance with recommendations.
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