June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Factors Influencing Follow-up Appointment Delays in Glaucoma Practices
Author Affiliations & Notes
  • Perrine G Tami
    Dalhousie University Faculty of Medicine, Halifax, Nova Scotia, Canada
  • Jayme R Vianna
    Ophthalmology & Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
  • Brennan D. Eadie
    Ophthalmology & Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
  • Footnotes
    Commercial Relationships   Perrine Tami, None; Jayme Vianna, Eadie Technologies (C); Brennan Eadie, Eadie Technologies Inc. (I), Labtician Thea (C)
  • Footnotes
    Support  2020 DMRF Gordon and Jean Hayman Studentships
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 1613. doi:
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      Perrine G Tami, Jayme R Vianna, Brennan D. Eadie; Factors Influencing Follow-up Appointment Delays in Glaucoma Practices. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1613.

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

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Purpose : Glaucoma specialists provide care for many patients who require regular follow-up appointments. As their practices grow, it can become increasingly difficult to see patients at the recommended follow-up intervals. This study aims to find the factors affecting follow-up delays using computer simulations.

Methods : Three glaucoma specialists were surveyed to estimate the number and severity of glaucoma patients seen in a typical week. Patient severity was categorized as suspects, early, or advanced, and assumed to require follow-up appointments at 52, 26, and 13-week intervals, respectively. Multiple simulations were performed, each creating a new practice for one glaucoma specialist starting with no patients. The survey responses were used to simulate a baseline practice. Further simulations varied multiple parameters to explore their effect on follow-up delays. Simulation parameters included: number of new and maximum follow-up patients per week, patient severity distribution, patient chance of progression and loss of follow-up, proportion of patients discharged, appointment interval spacing (increasing the appointment interval if the patient is stable). For each simulation, we computed the week patients began to have delays and the increasing rate in the weekly mean delay (mean of the delay of patients seen in that week).

Results : The baseline practice had 30 new patients and a maximum of 120 follow-up patients per week. This practice started having follow-up delays at week 111, and the weekly mean delay increases at a rate of 7 weeks of delay per week. Most explored factors had a minor impact on practices delays, including appointment spacing or patient discharging (Fig. 1). The factor most strongly associated with practices delays was the ratio of new to follow-up patients per week (Fig. 2).

Conclusions : Most glaucoma practices are not able to follow patients within the required appointment intervals. While discharging and spacing stable patients reduce practices follow-up delays, these methods are insufficient to avoid large delays over the years. Practices need to reduce the number of new patients to avoid large delays in follow-up appointments; however, this could affect the wait times for initial appointments.

This is a 2021 ARVO Annual Meeting abstract.




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