Implementation of the Glaucoma Computerized Adaptive Testing System (GlauCAT) to measure the quality of life (QoL) among glaucoma patients in a tertiary eye care setting

Abstract

Purpose : This study aims to assess: (a) the feasibility of GlauCAT in a busy glaucoma clinic; and (b) the correlation of patients’ responses on five QoL domains with the severity of glaucoma.

Methods : We conducted a cross-sectional study of 138 English-speaking adults aged ≥18 years attending a tertiary eye center glaucoma clinic. Patients with a history of intraocular surgery 90 days before enrollment and/or with cognitive impairment were excluded. GlauCAT, a tablet-based survey, uses item banks and CAT methods to measure the impact of glaucoma and its treatments on five QoL domains listed in Table 1. The domain scores ranged between 1-100, with higher scores representing better QoL outcomes. Feasibility was assessed using a 4-point satisfaction survey and the percentage of patients who completed GlauCAT without assistance. Differences in scores between glaucoma severity groups were assessed using the Kruskal-Wallis test.

Results : 69.6% of patients who completed GlauCAT did so without assistance. The satisfaction survey score had a mean of 3.49±0.53; no statistically significant difference in mean scores was found between the severity groups (p= 0.8). The mobility domain score was higher, with a mean of 93.3±8.6, in the glaucoma suspect group compared to 91.7±11.9 in the early glaucoma group and 79.5±27.1 in the moderate-severe group (p=0.001). The same trend was observed in the concerns domain; the moderate-severe glaucoma group had a significantly lower mean score of 69.8±19.8, followed by the early glaucoma group with 81.1±14.5 and the glaucoma suspects group with a mean of 86.3±8.9 (p=0.001). There was also a significant difference in activity limitation scores by severity group, with higher scores in the glaucoma suspect group (mean 87.0±15.3) than in the moderate-severe glaucoma group (mean 72.8±25.1, p=0.003). The ocular comfort and emotional well-being domains were not statistically significantly different between the three groups of glaucoma severity (p=0.776 and p=0.149, respectively).

Conclusions : Patients with more severe disease reported greater limitations. GlauCAT is a promising tool for assessing and monitoring glaucoma patients’ QoL, as it can be self-administered with high patient satisfaction.

This is a 2021 ARVO Annual Meeting abstract.