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Mona A Kaleem, Sheila K West, Lily Im, Bonnielin K Swenor; Referral to Low Vision Services for Glaucoma Patients. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5186.
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© ARVO (1962-2015); The Authors (2016-present)
A leading cause of low vision in the U.S. is glaucoma. More than 90% of those with low vision stand to benefit from rehabilitation services; however, service rates are startlingly low. The purpose of this investigation is to identify characteristics of glaucoma specialists with high and low referral rates to low vision services.
An online survey was distributed to members of the American Glaucoma Society (AGS), which consisted of 30 questions about practitioner demographics, characteristics of patient population, criteria for referral, familiarity with low vision services, and barriers to referral. Respondents were categorized into high referrers – those who reported referring 6 or more patients to low vision services per month – and low referrers – those who reported referring less than 6 patients per month. To compare characteristics between high and low referrers, chi-square tests were used to compare categorical variables and t-tests were used to compare continuous variables. Logistic regression analyses were used to calculate odds ratios (OR) and 95% confidence intervals (CI) and determine factors associated with referrer status.
The survey was completed by 207 out of 1029 AGS members (participation rate 20.1%). High referrers to low vision services tended to be in academic practice (50% vs. 38%, p=0.217) and were more likely to have more than 10 patients per month who had already seen a low vision provider (53% vs. 10%, p<0.001). High referrers tended to have information on low vision services in the office compared to low referrers (91% vs. 79%, p=0.081), High referrers were more likely to report using American Academy of Ophthalmology’s (AAO) Preferred Practice Pattern (PPP) guidelines for low vision referrals (18% vs. 38%, p = 0.011), and more likely to be satisfied with their current referral practices (86% vs. 70%, p=0.049). In the fully adjusted model those who used PPP patterns were 2.5 times more likely to report being a high referrer as compared to a low referrer (95% CI: 1.1-5.3). The number of years in practice, volume of patients seen each week, and distance to a low vision clinic were not associated with rates of referral.
The presence of information on low vision in the office and greater practitioner experience with low vision services and guidelines seems to positively influence likelihood of referral.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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