Subathra G N, Rajendrababu Sharmila R, Senthilkumar Vijayalakshmi A, Mani Iswarya, Udayakumar B
Department of Glaucoma, Aravind Eye Hospital, Madurai, Tamil Nadu, India.
Department of Biostatistics, Aravind Eye Hospital, Madurai, Tamil Nadu, India.
Indian J Ophthalmol. 2021 May;69(5):1264-1270. doi: 10.4103/ijo.IJO_164_21.
COVID-19 pandemic has affected the healthcare system worldwide hindering the continuum of treatment of chronic disease patients. The objective of the study is to analyze the barriers encountered by the glaucoma patients for the follow-up visit and medication adherence during the pandemic.
This cross-sectional study included glaucoma patients who did not attend the scheduled appointment from April 1, 2020 to July 31, 2020 in a tertiary eye care center (88.21%). Eligible patients of age >18 years and advised antiglaucoma medication in Madurai Zone were interviewed with validated questionnaire through telephonic call.
363 patients answered the questionnaire through telephonic interview. 57.3% of the patients were found to be non-adherent to medication. The main barriers for glaucoma follow-up visit during the pandemic were lockdown restriction, transport problem, and financial difficulties. The top barriers for medication adherence were non availability of medication (54.81%), financial difficulties (30.29%), did not feel much improvement with eye drops (20.19%). On multiple regression analysis, longer distance to hospital, low socioeconomic status, more than one antiglaucoma medication use, lack of awareness of glaucoma, non-complaint before COVID-19 and stress due to the pandemic were found to be significant factors for medication non adherence.
COVID-19 pandemic has emphasized the need for reformation in health care system for accessibility of medical care to patients in rural areas. Decentralization of health system to primary care level and utilization of teleophthalmology should be considered by health care planners in future.
新冠疫情影响了全球医疗体系,阻碍了慢性病患者的持续治疗。本研究的目的是分析青光眼患者在疫情期间随访和药物依从性方面遇到的障碍。
这项横断面研究纳入了2020年4月1日至2020年7月31日在一家三级眼科护理中心未按预约就诊的青光眼患者(88.21%)。对马杜赖地区年龄>18岁且被建议使用抗青光眼药物的符合条件的患者,通过电话访谈使用经过验证的问卷进行调查。
363名患者通过电话访谈回答了问卷。发现57.3%的患者未坚持用药。疫情期间青光眼随访的主要障碍是封锁限制、交通问题和经济困难。药物依从性的首要障碍是药物无法获取(54.81%)、经济困难(30.29%)、滴眼药后感觉改善不明显(20.19%)。多元回归分析发现,距离医院较远、社会经济地位低、使用一种以上抗青光眼药物、对青光眼缺乏认识、新冠疫情前不遵医嘱以及疫情导致的压力是药物不依从的重要因素。
新冠疫情凸显了医疗体系改革的必要性,以确保农村地区患者能够获得医疗服务。医疗规划者未来应考虑将卫生系统下放到基层医疗层面并利用远程眼科。