Poon Kip Hoe, Yeo Sharon, Tong Louis
Singapore Eye Research Institute, Singapore.
Singapore Eye Research Institute, Singapore ; Singapore National Eye Centre, Singapore ; Yong Loo Lin School of Medicine, Singapore ; Duke-NUS Graduate Medical School, Singapore.
Patient Prefer Adherence. 2014 Oct 9;8:1409-18. doi: 10.2147/PPA.S68147. eCollection 2014.
Dry eye is a prevalent condition with significant socioeconomic burden. This study evaluates the extent and reasons for loss to follow-up (LTF) in a dedicated dry eye clinic. LTF refers to patient who discontinued visits for >2 years.
The proportion of patients LTF and the demographics in a cohort of dry eye patients (2006 to 2010) were determined. A telephone survey was prospectively conducted for patients who were LTF.
Of 505 patients, 240 (47.5%) were LTF. Associated demographic factors for LTF were male sex, non-Chinese ethnicity, and age group <30 years old (all P<0.05). The reasons for LTF through the telephone survey (response rate 77.9%) were categorized into three broad groups, stabilized dry eye condition (47%), personal/social factors (25%) and perceived insufficiency of healthcare delivery (28%). Only two (1.1%) were considered as management failures. The younger patients (age <50 years) were more likely to become LTF (P<0.001) due to stabilized dry eye disease, compared to older patients who were more likely to be LTF due to personal/social reasons (P=0.02). Poor communication and service factors under healthcare delivery were found to be higher (P=0.002) in those who visited once before they were LTF (8.5%) compared to those who visited multiple times before they were LTF (0.1%).
LTF was relatively common in hospital-based dry eye management. Female and older patients were less likely to stop consultation. Stabilized dry eye condition, common in younger patients, was the most common reason for LTF. Elderly patients have difficulty attending clinics due to nonmedical problems, which may require a more holistic approach.
干眼症是一种普遍存在的疾病，具有重大的社会经济负担。本研究评估了一家专门的干眼症诊所中失访（LTF）的程度及原因。LTF是指连续两年以上停止就诊的患者。
确定一组干眼症患者（2006年至2010年）中LTF患者的比例及其人口统计学特征。对LTF患者进行前瞻性电话调查。
505例患者中，240例（47.5%）失访。与LTF相关的人口统计学因素为男性、非华裔以及年龄小于30岁（均P<0.05）。通过电话调查（应答率77.9%）得出的LTF原因可分为三大类：干眼症病情稳定（47%）、个人/社会因素（25%）以及认为医疗服务不足（28%）。仅2例（1.1%）被视为管理失败。与因个人/社会原因更易失访的老年患者相比（P=0.02），年轻患者（年龄<50岁）因干眼症病情稳定而更易失访（P<0.001）。在失访前就诊过一次的患者中，发现医疗服务中的沟通和服务因素较差（P=0.002）的比例为8.5%，而在失访前就诊过多次的患者中这一比例为0.1%。
在医院进行的干眼症管理中，失访情况相对常见。女性和老年患者停止咨询的可能性较小。年轻患者中常见的干眼症病情稳定是失访最常见的原因。老年患者因非医疗问题就诊困难，这可能需要采取更全面的方法。
