July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Health Literacy, Adherence, and Quality of Life in Uveitis Patients
Author Affiliations & Notes
  • Claire Mueller
    Emory University School of Medicine, Atlanta, Georgia, United States
  • Ghazala O'Keefe
    Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, United States
  • Footnotes
    Commercial Relationships   Claire Mueller, None; Ghazala O'Keefe, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 6697. doi:
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      Claire Mueller, Ghazala O'Keefe; Health Literacy, Adherence, and Quality of Life in Uveitis Patients. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6697.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : Uveitis is a leading cause of ocular morbidity with strong socioeconomic impacts. Poor health literacy and nonadherence are barriers to adequate care that have not been studied in uveitis. We performed a cross-sectional study of uveitis patients treated at a major county hospital in Atlanta, Georgia to determine health literacy, adherence, and quality of life to understand how to deliver better care given prior work showing the multidisciplinary needs of this unique population.

Methods : Prospective assessments of health literacy, adherence, and quality of life were obtained from 60 patients between June and October 2018 using Short Assessment of Health Literacy (SAHL), Beliefs about Medicine Questionnaire (BMQ), and 12-item Short Form Health Survey (SF-12), respectively, as well as a retrospective chart review. Another questionnaire addressed demographic information.

Results : Demographics: 43% were men and 57% women, with a mean age of 47.5 (21-75). 80% identified as Black. 16% did not complete high school, 42% completed high school or a GED, and 42% had further schooling. 32% of patients earned < $5,000 in annual household income. 85% of patients earned < $40,000. No patient earned > $70,000. 27% were uninsured.

Uveitis: 70% had bilateral disease. 43% anterior, 20% intermediate, 5% posterior, 25% panuveitis, and 18% scleritis. 19% of patients had infectious etiologies.

Health Literacy: Mean SAHL was 13.9 (4.1), with >14 indicating adequate health literacy. 44% were categorized as having poor health literacy. SAHL for those with less schooling was lower compared to those with more schooling (p<0.0001).

Adherence: Mean BMQ Necessity and Concerns were 3.7 (1.0) and 3.2 (1.5), respectively. Necessity scores were higher for rheumatology patients (p=0.038).

Quality of Life: SF-12 Physical (PCS) and Mental Component Scores (MCS) were lower among uveitis patients than the general US population (p<0.001 and p=0.002, respectively.) PCS was higher for rheumatology patients (p=0.008).

Conclusions : Uveitis patients reported many barriers to care, and almost half had poor health literacy. Despite strong perceptions of treatment necessity there were concerns about treatment and significantly poorer quality of life compared to normal subjects. Rheumatology patients indicated increased adherence and physical quality of life. Patient education and co-management with other specialties may be beneficial in improving adherence and quality of life.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.




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