Abstract
Purpose :
Treatment and follow-up adherence are important factors in the successful management of glaucoma, and are currently understudied in the prisoner population. In this study, we sought to compare the differences in demographics, disease characteristics, and follow-up times between incarcerated and non-incarcerated patients with glaucoma.
Methods :
We performed a retrospective chart review of UIC glaucoma visits from January 2015 to December 2017. All prisoners presenting to the glaucoma clinic over the study period were included. Age, sex, and race matched controls were selected from non-incarcerated patients in the same clinic over the same period of time. Demographics, clinical findings, interventions, and follow-up information were recorded. Statistical analysis included student t-test, one-way analysis of variance, or chi-squared test, as appropriate.
Results :
14 prisoners and 24 non-incarcerated patients (controls) were included in the study. All patients were male. Mean age was 54.2 +/- 10.6 for the prisoners and 56.8 +/- 9.7 for the controls (p=0.44). A majority of patients were black (87.5% in controls and 78.6% in prisoners). Disease distribution was similar in both populations; primary open angle glaucoma (POAG) was the most common diagnosis (44.0% in prisoners, 37.5% in controls), followed by POAG suspect (24.0% in prisoners, 16.7% in controls). Prisoners were seen 2.1 times over the study period, while controls were seen 4.2 times. Follow-up adherence was significantly worse for prisoners versus controls. Follow-up visits for controls occurred 11.7 +/- 5.8 days later than their recommended follow-up date, while prisoners were seen 177.8+/-34.2 days later (p<0.0001). A substantially higher proportion of prisoner follow-up visits were delayed by at least one month when compared to controls (66.7% vs 12.3%, respectively). Ultimately, 42.8% of prisoners were lost to follow-up, compared to 12.5% of controls.
Conclusions :
Despite being in a regimented institution where transportation, appointment attendance, and medication administration are controlled, adherence to follow-up visits remains a significant problem among the prisoner population. Various social, logistical, and communication issues may contribute to adherence issues, and warrant further study.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.