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Clinical Sciences
July 2011

Racial and Ethnic Disparities in Adherence to Glaucoma Follow-up Visits in a County Hospital Population

Author Affiliations

Author Affiliations: Departments of Ophthalmology, Stanford University, Stanford, California (Drs Murakami, Lee, and Singh and Mr Duncan), University of California, San Francisco (Drs Kao and Lin), and National Taiwan University Hospital, Taipei, Taiwan (Dr Huang).

Arch Ophthalmol. 2011;129(7):872-878. doi:10.1001/archophthalmol.2011.163

Objectives To identify predictors of inconsistent attendance at glaucoma follow-up visits in a county hospital population.

Methods Prospective recruitment from August 1, 2008, through January 31, 2009, of 152 individuals with glaucoma, with 1-to-1 matching of patients (those with inconsistent follow-up) and controls (those with consistent follow-up). Data were collected via oral questionnaire. Survey results were correlated with attendance at follow-up examinations, using the t test, χ2 test, and multivariate stepwise logistic regression analysis to calculate the odds ratios (ORs) and 95% confidence intervals.

Results After adjusting for covariates in the logistic regression analysis, factors independently associated with inconsistent follow-up included black race (adjusted OR, 7.16; 95% confidence interval, 1.64-31.24), Latino ethnicity (adjusted OR, 4.77; 1.12-20.29), unfamiliarity with necessary treatment duration (adjusted OR, 3.54; 1.26-9.94), lack of knowledge of the permanency of glaucoma-induced vision loss (adjusted OR, 3.09; 1.18-8.04), and perception that it is not important to attend all follow-up visits (adjusted OR, 3.54; 1.26-9.94).

Conclusions Demographic factors, including race and ethnicity, may directly or indirectly affect adherence to recommended glaucoma follow-up visits. Lack of information regarding irreversible vision loss from glaucoma, need for lifelong treatment, and lack of visual symptoms may be significant barriers to follow-up in this population. Targeted glaucoma education by physicians may improve follow-up, thereby decreasing the morbidity associated with glaucomatous disease.