Kanu Levi N, Oh Daniel J, Jang Inae, Henry Michael, Mehta Amy A, Dikopf Mark S, Vajaranant Thasarat S, Aref Ahmad A, Edward Deepak P
Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, IL, USA.
Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.
J Curr Ophthalmol. 2021 Jul 5;33(2):177-181. doi: 10.4103/joco.joco_207_20. eCollection 2021 Apr-Jun.
To evaluate medication and follow-up adherence in incarcerated patients examined at an academic glaucoma clinic, in comparison to nonincarcerated controls.
Retrospective, case-control study. Consecutive prisoners presenting for initial visits in the Glaucoma Clinic at the Illinois Eye and Ear Infirmary between December 2015 and December 2017 were included in the study. Nonincarcerated patients seen in the same Glaucoma Clinic with similar initial visit dates, age, race, sex, and disease severity were selected as controls. Glaucoma Clinic visits from each patient were reviewed until December 2018. Examination information, surgical intervention, follow-up and treatment recommendations, and patient-reported medication usage were recorded for each visit. Number of visits, loss to follow-up, follow-up delays, and medication nonadherence were studied as primary outcome measures.
Twenty-four prisoners and 24 nonincarcerated controls were included. Prisoners had an average of 2.46 ± 2.38 visits during the study period, compared to 5.04 ± 3.25 for controls ( = 0.001). Follow-up visits occurred more than 30 days after the recommended follow-up time in 57.4% (95% confidence interval [CI]: 44.2%-70.6%) of prisoners, compared to 17.9% (95% CI: 10.2%-25.6%) of controls ( < 0.00001). 70.8% of prisoners (95% CI: 66.3-74.5%) were lost to follow-up, compared to 29.2% of controls (95% CI: 25.5%-32.9%; < 0.01). Medication nonadherence rates were similar between prisoners (13.6%; 95% CI: 12.1%-15.2%) and controls (12.0%; 95% CI: 11.4%-12.6%; = 0.78).
Glaucoma follow-up adherence was significantly worse in prisoners compared to a nonincarcerated control population. Further study into causative factors is needed.
与非监禁对照者相比，评估在一家学术性青光眼诊所接受检查的被监禁患者的药物治疗依从性和随访依从性。
回顾性病例对照研究。纳入2015年12月至2017年12月期间在伊利诺伊州眼耳医院青光眼诊所首次就诊的连续囚犯。选择在同一青光眼诊所就诊、初始就诊日期、年龄、种族、性别和疾病严重程度相似的非监禁患者作为对照。对每位患者的青光眼诊所就诊情况进行回顾，直至2018年12月。记录每次就诊的检查信息、手术干预、随访和治疗建议以及患者报告的药物使用情况。将就诊次数、失访、随访延迟和药物治疗不依从作为主要观察指标进行研究。
纳入24名囚犯和24名非监禁对照者。在研究期间，囚犯平均就诊2.46±2.38次，而对照者为5.04±3.25次（P = 0.001）。57.4%（95%置信区间[CI]：44.2%-70.6%）的囚犯随访就诊时间在推荐随访时间30天之后，而对照者为17.9%（95%CI：10.2%-25.6%）（P < 0.00001）。70.8%的囚犯（95%CI：66.3%-74.5%）失访，而对照者为29.2%（95%CI：25.5%-32.9%；P < 0.01）。囚犯和对照者的药物治疗不依从率相似（囚犯为13.6%；95%CI：12.1%-15.2%，对照者为12.0%；95%CI：11.4%-12.6%；P = 0.78）。
与非监禁对照人群相比，囚犯的青光眼随访依从性明显更差。需要进一步研究其致病因素。
