Abstract
Abstract: :
Purpose: Research has shown that doctor–patient communication is a key determinant of patient satisfaction. The purpose of this study was to identify patterns of doctor–patient communication in a population of U.S. glaucoma patients and to assess the impact of such communication on patient behavior. Methods: A stratified sample (n = 22,000) from the subscribers to the Glaucoma Research Foundation (GRF) newsletter was invited to complete a self–administered questionnaire. Survey items included patient knowledge about glaucoma, relationship with current physician, and attitude toward medication side effects. Surveys were analyzed using Z–tests for proportions. Results: Responses were received from 4310 glaucoma patients. The majority of respondents were female (69%) and older than 72 years (51%). Glaucoma sub–types included open–angle (47%), normal tension (7%), angle–closure (6%), and ocular hypertension (4%), other (6%), and unknown (30%). The majority of physicians (54%) apparently communicate in a patient–centered manner and provide adequate explanations of glaucoma, the importance of controlling intraocular pressure (IOP), and the potential long–term risks to vision. Other physicians (42%) apparently communicate with their patients in a paternalistic manner and may underestimate long–term risks. Overall, respondents appeared to be satisfied with the quality of care they receive from ophthalmologists. Seventy–one percent of patients have never changed ophthalmologists. Of those that have switched doctors, however, 60% did so because their doctor did not explain their disease or treatment, 20% because the patient wanted a lower IOP, and only 6% because of ocular side effects. Most patients rate efficacy of medication more highly than possible side effects: 87% of patients would continue to comply with their prescribed medication even if they were to experience hyperemia or iris pigmentation. Conclusion: Most physicians explain the concept of IOP and the rationale for medical treatment well. Although most patients have not changed ophthalmologists, the majority of those that switched did so because the physician did not explain enough about the patient’s condition and treatment.
Keywords: clinical (human) or epidemiologic studies: outcomes/complications • quality of life • intraocular pressure