Purchase this article with an account.
T. Uhler, U. Altangerel, W. Steinmann, J. Henderer; Community Glaucoma Screenings: Assessment of Interventions to Improve Follow-up . Invest. Ophthalmol. Vis. Sci. 2003;44(13):171.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: To determine the effect of three interventions on follow-up of subjects identified in a community screening program and referred for a full exam. Methods: Previously, review of 422 free, community glaucoma screenings at Philadelphia senior centers identified forgetfulness and transportation issues as the main barriers to completing a follow-up exam. We are currently enrolling positively screened subjects into a randomized, prospective trial evaluating three interventions to improve follow-up. Since September 2002, 32 persons have been referred for further evaluation and randomly assigned to one of three interventions. Group I subjects receive $10 vouchers for reimbursement of transportation expenses and are contacted at the end of three months to assess follow-up. Group II subjects receive vouchers and monthly telephone calls until follow-up is confirmed or the end of 3 months. Group III subjects receive vouchers, monthly calls, and personal contact at the senior center, if necessary. If no exam is completed, subjects are queried as to why and assistance with follow-up arrangements is provided. Results: 9, 14, and 11 subjects are enrolled in Groups I, II, and III, respectively, with follow-up from 22 to 93 days. In Group I, 1/9did not follow-up because she did not remember the screening. 1/9 has not yet been contacted. 7/9 have not been contacted because they have been enrolled for less than 3 months. In Group II, 4/12 have followed up. 3/12 cannot be contacted. 5/12 did not follow-up yet because they were too busy, forgot, or could not afford co-pay; each of these plans to follow-up within the next 3 to 4 months. In Group III, 2/11 did follow-up. 6/11 have not followed-up because they forgot, changed doctors, did not have transportation, denied an eye problem, or passed away. 3/11 have been enrolled for less than 1 month. Conclusions: Preliminary results suggest that follow-up patterns may not be improved with vouchers, telephone calls and contact through a senior center. Overall follow-up remains poor; of those who could be contacted to date, 38.8% had an exam as compared to the follow-up rate of 42.1% in the previous study with no intervention. Longer study time and other interventions may yield improved results. Other measures are needed in similar populations to facilitate follow-up if screenings are to be effective.
This PDF is available to Subscribers Only