Abstract
Purpose :
50% of U.S. patients are now receiving an After Visit Summary (AVS), the potential benefits remain unknown.Goals of the AVS are to help patients remember their interactions with the care team and follow their medical regimen.We performed an observational clinical study to identify whether receiving an AVS would result in higher rates of glaucoma medication recall.
Methods :
A questionnaire was administered to 119 adults with glaucoma from the Faculty Practice at Mount Sinai to obtain perspectives on the AVS and assess whether it enhanced medication recall.A chart review was performed to collect current medications.The primary outcome measure was glaucoma medication recall using a 3 point scoring system.1 point each for correct identification of medications (by name or bottle description), treatment eye(s), and dosing regimen.New patients were excluded.Data was analyzed using an unpaired two-sample Welch's t-test assuming unequal variance.
Results :
Mean (±SD) patient age was 69.7±12.9 years. 55.9% of patients received an AVS within the past 12 months.66.7% reported reading it and 33.3% kept it for future use.65.5% of patients reported it to be very useful in maintaining eyedrop regimen and remembering future appointments.Patients who received an AVS had a lower recall (2.4±1.0) versus those who did not receive an AVS (2.7±0.6).80% of patients who received the AVS correctly identified their dosing regimen compared to 89% of patients who did not receive the AVS, significant difference, (p=.04). 76.5% of patients reported a college education and 23.5% reported less education.Medication recall was higher (p=0.01) in patients who completed college (2.7±0.7) compared to patients with less education (2.1±1.2).There were no differences in medication recall vs. age (p=0.19), or medication recall vs. number of glaucoma medications prescribed (p=0.20).
Conclusions :
The AVS is designed as a tool to enhance patient care, results of this study indicate this goal is not achieved consistently. In order for the AVS to have a significant impact, further assessment is needed to understand the barriers and perspectives of patients that do not read, keep, or find the AVS to be useful.Level of education appears to be a barrier to medication recall.More research needs to be done on whether modifying the current AVS will have a greater and consistent impact on medication recall and health outcomes.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.