Abstract
Purpose :
Glaucoma is one of the leading causes of irreversible blindness in the United States, affecting nearly 3 million. This number is expected to rise to 6.3 million by the year 2050. We performed a cross-sectional study investigating the interactions between Social Determinants of Health (SDOH), self-reported non-adherence, and Glaucoma Severity (GS) in vulnerable patients.
Methods :
Participants that met inclusion criteria of confirmed clinical diagnosis of glaucoma, on medical therapy, at an academic medical center in Newark, NJ serving a widely underserved population (Median Income $20k) were randomly enrolled. All participants completed a structured survey in their preferred language (English or Spanish) consisting of demographic information, self-reported adherence and Short Assessment of Health Literacy (SAHL). Subjects unwilling to complete surveys were excluded. Objective data included Visual Field Mean Defect (MD). Survey scores were correlated with demographic and objective data. Participants were compared based on mild or severe glaucoma severity (MD <-12dB, MD >-12dB, respectively) and high or low health literacy (score: 15-18 and 0-14 correct, respectively). Continuous data was compared using analysis of variance (ANOVA) and t-tests.
Results :
61 participants met inclusion criteria, with a median age of 62 years. The majority of participants were female (65.5%), Black (48%), and had a low education (no diploma or high school only, 57.3%). Participants who classified as severe (N=25) more often reported having high school education or less (60% ), greater difficulty accessing medication (60%), and lack of adherence (59%). Severe glaucoma was associated with low-health literacy(P<.05). Participants lost to follow-up, 75% classified as having low health literacy and no education. The association between glaucomatous severity, education level, and health literacy level was significant (p<.05). Average mean defect was calculated for each demographic (Table 1).
Conclusions :
Patients with vulnerable demographic risk-factors may have a higher burden of severe glaucoma and difficulty with adherence. This pilot study supports that various SDOH may predict GS and loss to follow-up. Further studies need to be conducted on larger populations to guide appropriate preventative intervention for identified patients.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.