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R. Singh, A. P. Singh, A. Flaum, K. Grant-Acquah, D. Kiernan, N. James, W. Mieler, R. D. Jager; Comparative Transatlantic Survey of Patient Knowledge and Awareness of Hypertension and Its Effects on Eye Disease. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2132.
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To ascertain the awareness of hypertension and its link to eye disease amongst adult opthalmology patients. To perform a comparative analysis to look for differences in awareness between patients of large urban medical institutions in the UK and USA.
Questionnaires were handed to adult patients when attending opthalmology clinics in two major centers, in the Yorkshire Deanery UK and the University of Chicago, USA. 86 patients (31 in UK, 55 in USA) provided completed or mostly completed questionnaires (illegible entries were discarded, blank entries were treated as ‘don’t know’). 12 patients did not return the questionnaires.
27 patients stated they had hypertension, with a higher proportion of moderate-severe* hypertension in USA patients (11% v 6% UK). 33 patients (26% UK v 45% USA) managed to specify what normal* BP was, whilst 37 patients could not state what they thought a high* figure for BP would be. 36 did not know what their current blood pressure value was. Patients from the USA were significantly more informed on this issue. 46 patients (52% UK v 90% USA) stated that high blood pressure may affect the eye, though only 21 stated a correct effect and 10 patients (26% UK v 6% USA) stated there was no effect of blood pressure on eye disease. Patients from the USA were again significantly more informed. (*as defined by the BHS-IV guidelines on hypertension)
Though a majority of patients were aware of the deleterious impact of hypertension on the eye, most could not state what effect it may have (or stated an incorrect or lack of effect). Furthermore, almost half could not state their current BP level. Patients in the USA were generally better informed. Knowledge and involvement of patients in the management of their chronic diseases has been shown to improve outcomes. These results are therefore concerning - particularly for the UK population. Possible reasons for a transatlantic difference include a lower proportion of severe hypertension (attracting less medical attention), a difference in the general education level, a taxation funded service where patients do not directly contribute to treatment (and may have less incentive to optimize it), and relative resource constraints that may limit time in clinics to educate patients. It is important that patients are better educated about their disease, and involved in the decision making process.
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