改善青光眼就诊期间黑人患者的提问和医生教育。

Improving Black Patient Question-Asking and Provider Education During Glaucoma Visits.

机构信息

Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

出版信息

Ophthalmol Glaucoma. 2023 Mar-Apr;6(2):206-214. doi: 10.1016/j.ogla.2022.09.003. Epub 2022 Sep 19.

DOI:10.1016/j.ogla.2022.09.003

PMID:36967704

Abstract

PURPOSE

The objectives of this study were to conduct a randomized, controlled trial testing the effectiveness of a previsit glaucoma video/question prompt list intervention to increase Black patient question-asking and provider education about glaucoma and glaucoma medications during visits.

DESIGN

A randomized, controlled trial of a glaucoma question prompt list/video intervention.

PARTICIPANTS

Black patients with a glaucoma diagnosis who were currently taking 1 or more glaucoma medications and reported being nonadherent.

METHODS

One hundred and eighty-nine Black patients with glaucoma were enrolled into a randomized, controlled trial and assigned to either a usual care or an intervention group where they watched a video emphasizing the importance of asking questions and received a glaucoma question prompt list to complete before clinic visits. Visits were audiotaped and patients were interviewed after visits.

MAIN OUTCOME MEASURES

Outcome measures were if the patient asked 1 or more questions about glaucoma and glaucoma medications and the number of glaucoma and glaucoma medication areas the provider educated the patient about during the visit.

RESULTS

Patients in the intervention group were significantly more likely to ask 1 or more questions about glaucoma than patients in the usual care group (odds ratio, 5.4; 95% confidence interval [CI], 2.8-10.4). Patients in the intervention group were significantly more likely to ask 1 or more questions about glaucoma medications than patients in the usual care group (odds ratio, 2.8; 95% CI, 1.5-5.4). Patients in the intervention group were significantly more likely to receive more areas of education about glaucoma from their providers during visits (β = 0.94; 95% CI, 0.49-1.4). Patients who asked 1 or more questions about glaucoma medications were significantly more likely to receive more areas of education about glaucoma medications from providers (β = 1.8; 95% CI, 1.2-2.5).

CONCLUSIONS

The intervention increased patient question-asking about glaucoma and glaucoma medications and provider education about glaucoma.

FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.

摘要

目的

本研究旨在开展一项随机对照试验，以测试在就诊前观看青光眼视频/问题提示清单干预措施对增加黑人患者提问以及向其提供有关青光眼和青光眼药物信息的有效性，该措施旨在增加黑人患者在就诊期间对青光眼和青光眼药物的提问，并增加提供者对青光眼的教育。

设计

青光眼问题提示清单/视频干预的随机对照试验。

参与者

正在接受一种或多种青光眼药物治疗且报告不遵医用药的黑人青光眼患者。

方法

将 189 名黑人青光眼患者纳入一项随机对照试验，并将其分为常规护理组或干预组，干预组观看强调提问重要性的视频，并在就诊前完成青光眼问题提示清单。对就诊进行录音，并在就诊后对患者进行访谈。

主要观察指标

观察指标为患者是否就青光眼和青光眼药物提出 1 个或多个问题，以及提供者在就诊期间教育患者有关青光眼和青光眼药物的具体内容。

结果

干预组患者询问 1 个或多个与青光眼和青光眼药物相关问题的可能性显著高于常规护理组患者（优势比，5.4；95%置信区间 [CI]，2.8-10.4）。干预组患者询问 1 个或多个与青光眼药物相关问题的可能性显著高于常规护理组患者（优势比，2.8；95% CI，1.5-5.4）。干预组患者更有可能从其提供者处获得更多关于青光眼的教育（β=0.94；95% CI，0.49-1.4）。提出 1 个或多个与青光眼药物相关问题的患者，更有可能从提供者处获得更多关于青光眼药物的教育（β=1.8；95% CI，1.2-2.5）。