Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Eye (Lond). 2024 Feb;38(2):343-348. doi: 10.1038/s41433-023-02693-8. Epub 2023 Aug 14.
BACKGROUND/OBJECTIVES: Little is known about African American patient-provider communication about glaucoma-related quality-of-life. The objectives of this study were to: (a) examine associations between patient socio-demographics and vision quality-of-life, (b) describe the extent to which eye care providers and patients discuss glaucoma-related quality-of-life, and (c) examine associations between patient and provider characteristics, whether the patient was in the intervention or usual care group, and whether the patient and provider discuss one or more glaucoma-related quality-of-life domains.
Adult African American patients with glaucoma who reported non-adherence to glaucoma medications were enrolled from three sites. Patients completed a vision quality-of-life VFQ-25 assessment. Patients were randomized into intervention and control groups with intervention group members receiving a glaucoma question prompt list and watching a video before a provider visit. Audio recordings from these visits were transcribed and assessed for glaucoma-related quality-of-life discussions.
One hundred and eighty-nine patients were enrolled. Glaucoma-related quality-of-life was discussed during 12.3% of visits (N = 23). Patients initiated discussion 56.5% (N = 13) of the time and providers 43.5% (N = 10) of the time. Patients with worse health literacy (p < 0.001), more depressive symptoms (p < 0.05), and more severe glaucoma (p < 0.001) were significantly more likely to have worse vision-related quality-of-life. Glaucoma-related quality-of-life was significantly more likely to be discussed when African American patients saw African American providers (p < 0.05).
Patients and providers rarely discussed the patient's glaucoma-related quality-of-life. The intervention did not significantly increase communication about glaucoma-related quality-of-life. Residency programs should consider enhancing training regarding discussing patients' quality-of-life.
背景/目的：关于非裔美国患者与医疗服务提供者在青光眼相关生活质量方面的沟通，目前知之甚少。本研究的目的是：(a) 检验患者社会人口统计学特征与视觉生活质量之间的关联；(b) 描述眼科医疗服务提供者与患者讨论青光眼相关生活质量的程度；(c) 检验患者和提供者特征、患者是否处于干预组或常规护理组、以及患者和提供者是否讨论一个或多个青光眼相关生活质量领域之间的关联。
从三个地点招募了报告不遵医使用青光眼药物的成年非裔美国青光眼患者。患者完成了视觉生活质量 VFQ-25 评估。患者被随机分配到干预组和对照组，干预组患者在就诊前接受青光眼问题提示清单并观看视频。对这些就诊的音频记录进行转录并评估青光眼相关生活质量讨论情况。
共纳入 189 名患者。在 12.3%的就诊中讨论了青光眼相关生活质量（N=23）。患者发起讨论的次数占 56.5%（N=13），而提供者发起讨论的次数占 43.5%（N=10）。健康素养较差（p<0.001）、抑郁症状较多（p<0.05）和青光眼更严重（p<0.001）的患者，其视觉相关生活质量更差的可能性显著更高。当非洲裔美国患者看到非洲裔美国医疗服务提供者时，青光眼相关生活质量更有可能得到讨论（p<0.05）。
患者和提供者很少讨论患者的青光眼相关生活质量。该干预措施并未显著增加有关青光眼相关生活质量的沟通。住院医师培训项目应考虑加强关于讨论患者生活质量的培训。
