Abstract
Purpose :
In patients with primary open-angle glaucoma (POAG), psychosocial risk factors play an important role in morbidity and mortality. It is critical to identify patients with distress as early as possible to provide them with supportive resources. The aim of this study was to validate the distress thermometer (DT) in POAG patients and to explore the associations between distress, vision-related quality-of-life (vrQOL), self-efficacy and social support.
Methods :
POAG patients were prospectively recruited from the Duke Eye Center from September 2022 to August 2023. Patients were contacted by email prior to a glaucoma appointment and asked to complete surveys related to their distress, including DT, Hospital Anxiety and Depression Scale (HADS) and anxiety (HADS-A) and depression (HADS-D) subscales, NEI Visual Functioning Questionnaire 9-item scale, Self-Efficacy for Managing Chronic Disease 6-item scale, and the Modified Medical Outcomes Study Social Support Survey 8-item. Larger values of each scale indicate higher levels of the underlying measure. Summary statistics are presented as mean and standard deviation along with Spearman correlation (r) coefficients and p-values.
Results :
A total of 300 patients (age 68.44 (12.60), 52% female, 81% white) were included. Patients reported a mean DT of 3.37 (2.59). One-hundred thirty-two patients (44%) had a DT≥4, indicating moderate or severe distress. The mean HADS score was 9.21 (6.28) with moderate or severe distress (HADS≥14) in 22% of patients. DT was strongly correlated with anxiety and depression (HADS total r = 0.67, P < 0.001), with the correlation being stronger with anxiety (HADS-A, r = 0.66, P < 0.001) than depression (HADS-D, r = 0.54, P < 0.001). For DT≥4, the sensitivity and specificity were 0.84 and 0.67, respectively, for detecting moderate or severe distress with an AUC of 0.82. DT was shown to have a moderate negative correlation with vrQOL (r = -0.28, P < 0.001), self-efficacy (r = -0.35, P < 0.001), and social support (r = -0.37, P < 0.001).
Conclusions :
Our study indicates that nearly half of POAG patients had relevant distress and that a brief screening tool can be used in glaucoma clinics. Increased vision-related quality-of-life, self-efficacy, and social support were associated with lower patient distress, highlighting the importance of non-pharmacological interventions to improve distress in POAG patients.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.