Abstract
Purpose :
Patient utilization of alternative healthcare providers is on the rise in the United States and the impact of this on chronic ocular disease patients is unknown. We performed a retrospective cross-sectional study using nationally representative data to analyze how patients with chronic ocular disease utilize alternative healthcare providers and determine if there was any association between alternative healthcare use and decreased adherence to prescription medication adherence.
Methods :
We used multivariate logistic regression models to evaluate the association between ocular disease, regular eye doctor visits, alternative healthcare provider visits, and skipping or using alternative medications to save money. Our study size was 5,264 participants with self-reported diagnoses of glaucoma, age-related macular degeneration, or diabetic retinopathy. These models were adjusted for potential confounders (gender, age, race, ethnicity, educational attainment, vision impairment, insurance status, poverty level, and presence of other medical conditions). We defined alternative healthcare providers as practitioners of homeopathy, naturopathy, traditional medicine as well as shamans, curanderos, machis, pacheros, yerberos, hierbistas, sobadors, Native American healers, and medicine men. All data came from the 2017 National Health Interview Survey (NHIS) and was analyzed using Stata version 16 (StataCorp, College Station, TX).
Results :
Participants with chronic ocular disease who utilized alternative healthcare providers were more likely to have regular eye care appointments (odds ratio [OR]: 1.76, 95% confidence interval [CI]: 1.14-2.72, P=0.01). These participants were also more likely to use alternative medications or skip medication doses to save money (OR: 5.31, 95% CI: 3.09-9.14, P<0.001 and OR:3.84, 95% CI: 1.84, 7.95, P<0.001, respectively).
Conclusions :
Regular eye care for patients with chronic ocular disease is important in preventing vision loss. Patients who utilize alternative care providers may be at higher risk for vision loss because of medication nonadherence. The underlying cause of the association of medication nonadherence and alternative healthcare utilization is still not clearly understood. More research is required to understand why patients are utilizing alternative care providers and why they are be more likely to be less compliant with their medication.
This is a 2021 ARVO Annual Meeting abstract.