Abstract
Purpose :
There is limited literature on post-ophthalmic surgery follow-up adherence, particularly in patient populations similar to our South Bronx clinic. We describe patient characteristics and the postoperative follow-up adherence in patients undergoing first-time ophthalmic surgery in order to identify risk factors for poor postoperative follow-up.
Methods :
A retrospective chart review was performed on 50 consecutive adult patients who had ophthalmic surgery in our BronxCare Hospital Center (BCHC) operating room or in our ambulatory surgery center (ASC) from January-December 2017. Data recorded included: type of surgery and anesthesia; intraoperative complications; age/sex/marital status; preferred language; residential distance to BCHC; number of preoperative systemic and topical medications; attendance on postoperative day 1 (POD1), week 1 (POW1) and month 1 (POM1); postoperative complications and attendance at any additional follow-up visits. Chi-squared test, Fisher’s exact test, Mann-Whitney test and two-tailed Student’s t-test were used for analysis.
Results :
25 patients were reviewed at each facility. Patients scheduled for routine follow-up had an attendance rate of 88%; patients asked to follow-up more frequently due to postoperative complications had an attendance rate of 72% (p=0.08). There was lower compliance for ASC patients at the POM1 visit (80% vs. 100%, p=0.050) and in the overall POD1-POM1 interval (76% vs. 100%, p=0.022) as compared to BCHC patients. The postoperative complication rate was 32% overall (18% BCHC, 14% ASC). Adherence was lower in patients who had a postoperative complication at either operating room as compared to no complications (55% vs. 83%, p<0.01). A greater variety of types of surgery were performed at BCHC as compared to ASC (p=0.04). Though there were no statistically significant differences between our BCHC and ASC patients, it is notable that the types of surgery performed at the ASC as compared to BCHC were predominantly cataract and simpler ocular surface procedures, and patients assigned to the ASC tended to be less burdened by systemic illness.
Conclusions :
We found two groups of patients at risk for poor compliance: 1) patients who underwent surgery at ASC; 2) patients who had postoperative complications. Rapid, uneventful postoperative recovery and a more burdensome follow-up for postoperative complications may be risk factors for decreased compliance.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.