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Kyle Hirabayashi, Madison Pomerantz, Stephanie Lauren Thomas, Janet B Serle; Recommendation for Patient-Centered After-Visit Summary for Patients with Glaucoma. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1255.
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While the after-visit summary (AVS) is being utilized by physicians, patient preference for the format and features of the AVS has not been considered in an outpatient ophthalmology setting. We performed a prospective, cohort clinical study to provide recommendations to create a more useful, concise, and patient-centered AVS for patients with glaucoma.
119 adults with glaucoma from the Faculty Practice at the Icahn School of Medicine at Mount Sinai completed a questionnaire on their experiences with the AVS. Patients with glaucoma taking one or more glaucoma medication were included in the study. New patients were excluded. The questionnaire consisted of forty-three questions regarding demographic information, use and usefulness of the AVS they had received that had been printed out from Epic, how to improve the AVS, and medication adherence.
Of the patients surveyed, 82.9% stated they would like to receive an AVS. Of these patients, 71.6% prefer paper format, while 28.4% prefer electronic format. Although ideal font size varied among patients, 93.9% of patients prefer font size 18 or smaller. 64% of patients prefer the AVS to be 1-3 pages, while 31.6% of patients prefer however many pages are necessary to fit all information. Over 75% of patients identified the following information as features they would like to see in their AVS: patient name, visit date, provider name, diagnosis from today’s visit, condition-specific instructions, ocular medications, and information on future visits. 70.1% of patients do not want their full medication list included in the AVS. While 38% of patients report using only the medication name to identify their medication, 53% of patients report using the color of the cap and 23% report using the shape of the bottle to aid in identifying their ocular medications.
The after-visit summary can be improved to reflect patient preference in order to create a more concise, patient-centered AVS. We recommend including name of the medication, color of the cap, and an image of the bottle when describing glaucoma medications. We also recommend printing the AVS, offering the option of an electronic version, limiting font size to 18 or smaller unless the patient requires larger font, and deleting the full medication list from the AVS. We believe that following patient preferences such as these can make the AVS a more effective communication tool.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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