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将选择性激光小梁成形术作为青光眼一线治疗方法的教育干预:随机对照试验:关于选择性激光小梁成形术的教育干预

Educational intervention to adopt selective laser trabeculoplasty as first-line glaucoma treatment: Randomized controlled trial: Educational intervention on selective laser trabeculoplasty.

作者信息

Tran Evelyn, Sanvicente Carina, Hark Lisa A, Myers Jonathan S, Zhang Qiang, Shiuey Eric J, Tran Judie, Bonafede Lucas, Hamershock Rose A, Withers Colleen, Katz L Jay

机构信息

Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.

Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA, USA.

出版信息

Eur J Ophthalmol. 2022 May;32(3):1538-1546. doi: 10.1177/11206721211018365. Epub 2021 May 27.

DOI:10.1177/11206721211018365
PMID:34041935
Abstract

PURPOSE

To determine the efficacy of an educational intervention on patient adoption and attitudes toward selective laser trabeculoplasty (SLT) as first-line treatment for glaucoma.

METHODS

This study is a randomized controlled trial. Subjects include 33 patients within 1-year diagnosis of either primary open-angle glaucoma, ocular hypertension, or pseudoexfoliation syndrome. After informed consent, subjects were randomly assigned to a Usual Care or Educational Intervention group. All subjects completed a pre-intervention questionnaire. The Educational Intervention group was shown a slideshow presentation and a 3-min video and given a post-intervention questionnaire. Follow-up examinations were reviewed for 6 months to determine subject completion of SLT, the primary outcome. Secondary outcomes include assessment of attitude toward SLT before and after intervention.

RESULTS

Age, gender, and baseline characteristics between the groups did not differ. The Usual Care group had a higher proportion of African Americans (77% vs 31%,  = 0.04). At 6 months following the intervention, 63% of subjects underwent SLT compared to 35% of Usual Care subjects ( = 0.12). Older age was associated with decreased SLT uptake (OR 0.90, 95% CI 0.82-0.99,  = 0.03). Prior to the intervention, there were no differences in attitudes of both groups regarding SLT therapy. Nineteen percent of Educational Intervention subjects changed positively toward SLT ( = 0.08) and 50% scheduled an SLT appointment after intervention ( = 0.005).

CONCLUSIONS

A slideshow and video-based educational intervention may positively enhance patient adoption of SLT.Clinical trial registration name, number, URL: Educational Intervention to Adopt SLT as First-Line Glaucoma Treatment, NCT03365778, https://clinicaltrials.gov/ct2/show/NCT03365778.

摘要

目的

确定一项教育干预措施对患者接受选择性激光小梁成形术(SLT)作为青光眼一线治疗方法的接受程度和态度的效果。

方法

本研究为随机对照试验。受试者包括33例在1年内被诊断为原发性开角型青光眼、高眼压症或假性剥脱综合征的患者。在获得知情同意后,受试者被随机分配到常规护理组或教育干预组。所有受试者均完成干预前问卷。教育干预组观看了幻灯片演示和一段3分钟的视频,并在干预后完成问卷。对随访检查进行了6个月的评估,以确定受试者完成SLT的情况,这是主要结果。次要结果包括干预前后对SLT态度的评估。

结果

两组之间的年龄、性别和基线特征无差异。常规护理组中非裔美国人的比例更高(77%对31%,P = 0.04)。干预后6个月,63%的受试者接受了SLT,而常规护理组的这一比例为35%(P = 0.12)。年龄较大与接受SLT的比例降低相关(OR 0.90,95%CI 0.82 - 0.99,P = 0.03)。在干预前,两组对SLT治疗的态度没有差异。19%的教育干预组受试者对SLT的态度转为积极(P = 0.08),50%的受试者在干预后预约了SLT治疗(P = 0.005)。

结论

基于幻灯片和视频的教育干预可能会积极提高患者对SLT的接受程度。临床试验注册名称、编号、网址:将SLT作为青光眼一线治疗方法的教育干预,NCT03365778,https://clinicaltrials.gov/ct2/show/NCT03365778。

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