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Rengaraj Venkatesh, kavitha srinivasan, Nazli Sonmez, Ryan Buell, Kamalini Ramdas; Shared Medical Appointments in Glaucoma Management at a Tertiary Care Eye Hospital - A Randomized Trial. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2116. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Glaucoma is a chronic disease and highly asymptomatic in early stages. Patients’ understanding and knowledge about the disease is important to improve compliance to treatment and follow up, and also to prevent progression. Shared medical appointments (SMAs), in which patients are examined by their physician as a group, have been found to be successful in managing chronic conditions like obesity, diabetes. The primary objective of this study was to examine how SMA affects the level of patient’s knowledge and satisfaction in glaucoma care provision.
A prospective randomized trial involving 265 patients was conducted involving primary glaucoma on treatment for one year. Fifty-three groups of five patients were randomly assigned to either the SMA or one-on-one (control) group. While one patient in the SMA group is being examined and treated, the other 4 in the group get to listen to them. Those in the one-on-one group engage with the doctor while the other 4 patients wait outside the consultation suite. During the appointment, patients in both conditions experience an eye examination and receive recommendations from the doctor, and have the opportunity to ask questions. After their examination, patients received a survey that included questions assessing their level of knowledge about glaucoma and their satisfaction level with the experience.
One hundred sixty patients were randomized into the one-on-one group while 105 were recruited into the SMA group. Patients randomized in the SMA group were 12% more satisfied with their appointment experience than patients who received a one-on-one appointment (p<0.05). In addition, glaucoma knowledge scores were 5% higher amongst patients randomized to the SMA group when compared to patients attending one-on-one appointments, though the differences were not statistically significant (p=0.31).
The results support the use of SMA in glaucoma management since it has a potential for increasing the satisfaction and knowledge level of patients. We believe, this will improve patient compliance and follow up rates, indirectly reducing the burden of glaucoma blindness.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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