Provision of Eye Care Provider Smoking Cessation Advice to Patients With Age-Related Macular Degeneration

Abstract

Purpose: : Age-related macular degeneration (AMD) is the leading cause of vision loss in the United States. As there is no effective treatment for all types of AMD, addressing modifiable risk factors is of great importance. Smoking is one of the few modifiable AMD risk factors for disease progression. Effective smoking cessation strategies in patients at high risk for the condition may possibly reduce the risk of developing AMD or having AMD progress to cause disabling visual impairment. However, little is known about the specific attitudes and smoking cessation practices among vision care providers and their patients. In the present pilot study, we examine patient and provider reports of smoking cessation advice in this patient population.

Methods: : In June 2009, 52 AMD patients at a large academic medical center completed an anonymous questionnaire in English and Spanish assessing smoking history and history of quit attempts. Forty-six eye care providers at the same facility completed an anonymous electronic questionnaire asking about their smoking cessation counseling practices.

Results: : Seventeen percent of AMD patients were smokers who, on average, visited an ophthalmologist 5 times per year. Nearly 90% reported "never" being advised to quit by their ocular eye care provider. Sixty percent of eye care providers indicated that they ascertain smoking status during patient examinations, and 48% assessed patient willingness to quit. Most eye care providers indicated they wanted additional patient smoking cessation materials and/or the ability to refer their patients to effective smoking cessation programs. When prompted to identify which smoking cessation training or information the ophthalmologist would like to use most with their respective patient population: 46% wanted training on how to select self-help materials to give their patients and 28% wanted to learn how to provide social support to their patients as part of their cessation treatment

Conclusions: : Findings from the present study suggest a desire on the part of eye care providers to do more for their smoking patients. Tailored smoking cessation programs may be needed for this unique patient population, yet to date, there has been little development of such programs.

Keywords: age-related macular degeneration • clinical (human) or epidemiologic studies: prevalence/incidence • clinical (human) or epidemiologic studies: risk factor assessment