April 2009
Volume 50, Issue 13
ARVO Annual Meeting Abstract  |   April 2009
Patient Empowerment in UK Glaucoma Care - Is There Consensus?
Author Affiliations & Notes
  • P. Shah
    Ophthalmology, Birmimgham and Midlands Eye Centre, Birmingham, United Kingdom
    University of Wolverhampton, Wolverhampton, United Kingdom
  • V. Cross
    University of Wolverhampton, Wolverhampton, United Kingdom
  • R. Cragg
    Institute of Clinical Leadership, Birmingham, United Kingdom
  • Footnotes
    Commercial Relationships  P. Shah, None; V. Cross, None; R. Cragg, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science April 2009, Vol.50, 2459. doi:
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      P. Shah, V. Cross, R. Cragg; Patient Empowerment in UK Glaucoma Care - Is There Consensus?. Invest. Ophthalmol. Vis. Sci. 2009;50(13):2459.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: : ‘Expert patient’ initiatives encourage patients as active, informed partners with professionals to optimise outcomes for their long-term health problems. In glaucoma this includes primary and secondary care practitioners, and community support groups. In partnership models of care patients are empowered to accept various responsibilities to optimise clinical interventions. Research indicates that lack of support from practitioners for patients with chronic disease is a significant barrier to partnership formation. This study, exploring partnerships in glaucoma, is part of the Birmingham ReGAE (Research into Glaucoma And Ethnicity) Project.

Methods: : Q-Methodology extracts and measures subjective attitudinal structures. It assumes a limited number of patterns within any particular discourse. It was used to identify viewpoints of 30 participants (experimental condition) towards development of glaucoma services, in response to 60 predefined constructs (variables). Exploratory cluster and factor analysis of responses revealed consensus and contentious perceptions among glaucoma patients, ophthalmic surgeons, optometrists, specialist ophthalmic nurses, orthoptists, and community support organisations on priorities for servicedevelopment.

Results: : Contentious analysis identified three clear viewpoints: (1) A ‘Traditionalist’ hospital-centric approach. (2) A ‘Patient Centric’ group advocated more community-based strategies for patient empowerment. (3) A third group supported an ‘Integrated Care’ model of care delivery. Participants were distributed across all three viewpoints with no group-specific viewpoint emerging. Consensus analysis revealed that irrespective of the preferred care model, closure of specialised hospital provision was unacceptable. Also, positive action to raise awareness of glaucoma across ethnic populations was deemed essential.

Conclusions: : The study examined a complex issue against the background of an unstable health economy. An unstable system militates against development of patient partnership initiatives. Opinions may vary with greater understanding and contextual stability.

Keywords: clinical research methodology • optic disc • intraocular pressure 

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