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Lisa A Hark, L. Jay Katz, Jonathan S. Myers, Julia A Haller; Philadelphia Telemedicine Glaucoma Detection and Follow-up Study: Adherence to Community Eye Exam Appointments. Invest. Ophthalmol. Vis. Sci. 2018;59(9):6154. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To improve eye exam appointment adherence following an innovative, practice-based eye screening model to detect, treat, and manage glaucoma in high-risk individuals in urban primary care practices (PCP) and federally qualified health centers (FQHC).
Our targeted, at-risk population included African-Americans, Hispanics and Asians over age 40; adults of any ethnicity over 65 or over age 40 with a family history of glaucoma or diabetes. Participants underwent a free telemedicine eye screening (Visit 1) which included non-mydriatic fundus photography, medical and ocular history, and intraocular pressure measurements in 7 PCPs and 4 FQHCs. Participants with abnormal images, unreadable images, or ocular hypertension were invited back to the same PCP or FQHC location for a confirmation eye exam by an ophthalmologist (Visit 2). Participants who attended Visit 2 and agreed to enroll were randomized to either the Intervention or the Usual Care group for follow-up eye exams with a private practice-community ophthalmologist (Visit 3) in a new location of their choice. The Intervention consisted of using patient navigators and a social worker to provide education about their eye condition and reduce barriers to eye care utilization over a 2-year period. Results are reported on the initial adherence to Visit 3 eye exam appointments comparing the Intervention and Usual Care groups.
Of 906 participants screened in the community, 535 (59.1%) were invited for an eye exam. Participants who attended the confirmation eye exam (n=347) and were randomized to the Intervention group (n=172) and the Usual Care group (n=172) were predominately female (59.9%) and African American (64.3%), with a mean age of 60.6 ±11.0 (range: 40.0-99.4) years. A total of 191 (55%) participants attended an initial follow-up eye exam with an ophthalmologist of their choice, and of those, 130 (68.1%) were participants who had been randomized to the Intervention group compared to 61 (31.9%) participants who were randomized to the Usual Care group (P<0.05).
There was a significantly higher adherence to eye exam appointments among participants assisted by patient navigators and a social worker. Our study presents a new perspective and showed that scheduling eye exam appointments and providing education about ocular diagnosis significantly improved adherence to follow-up eye care recommendations.
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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