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N. J. Ellish, R. Royak-Schaler; Patient-Physician Communication About Preventive Eye Care. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4977.
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Doctor-patient communication has been shown to significantly affect patient decisions about their health practices and the health outcomes that are related to these decisions. This communication process regarding recommendations for dilated fundus examinations (DFEs) has not been investigated in the ophthalmologic scientific literature. This study was designed to investigate this gap in knowledge from the perspective of community-dwelling African Americans, 65 years and older.
Between June 2006 and September 2007, 330 participants who had not had a DEE in the past two years were recruited from community venues. Participants were administered a questionnaire to collect information about their interaction with the health care system.
Our study population was predominantly female, with a mean age of 72.1 years. Twenty-eight people (9%) reported having glaucoma and 71 had diabetes (22%), with 11 participants reporting diabetic retinopathy (DR). Twenty-two percent reported never having had a DFE. Regarding their interaction with the health care system, 94% stated they had personal physicians whom they saw for their routine medical care. However, only 12% had been told to get a DFE by their physicians. The majority reported not being told about their risk factors for developing glaucoma (85%) or DR (66% of the diabetics). Of the 102 participants (32%) who stated they had problems seeing even with their glasses, 66% reported this had been ongoing for more than one year. In addition, only 20% of participants had discussed their eye concerns with their regular doctors. Thirty-seven percent of the participants expressed a preference for doctor-controlled medical decision-making.
Physicians who deliver primary care to older African American patients should confirm that they have had a recent DFE and assess any vision problems they may be having. Our data suggest that many individuals in this population who have eye disease or are having vision problems do not report these concerns or request guidance for dealing with them from their primary care providers.
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