Aziz Rem, Shah Asha, Moss Heather E
Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Faculty of Medicine, Cambridge Health Alliance, Cambridge, MA, United States.
Front Ophthalmol (Lausanne). 2021 Oct 22;1:770807. doi: 10.3389/fopht.2021.770807. eCollection 2021.
Idiopathic intracranial hypertension (IIH) is a chronic condition characterized by raised intracranial pressure of undetectable origin, that causes morbidity due to debilitating headaches and vision loss. Continuity of outpatient care is important to monitor for permanent vision loss, manage symptoms and limit emergency care. The purpose of this retrospective study was to identify factors associated with neuro-ophthalmology follow-up appointment completion among patients with IIH at a US academic medical center in order to establish evidence-based interventions to improve adherence patterns. Included are 111 completed or no-show neuro-ophthalmology return outpatient appointments by 23 subjects with IIH. Generalized estimating equation models were used to assess association between appointment completion status and factors previously shown to be associated with appointment adherence. Appointments were more likely to be completed during the summer (p=0.08) and by subjects with headache symptoms (p=0.06), however none of the patient factors reached statistical significance. Completed and no-show appointments did not differ by subject demographic or insurance factors. Further studies are needed to identify risk factors for lack of appointment adherence by patients with IIH, particularly those amenable to intervention, in order to improve continuity of care for IIH.
特发性颅内高压(IIH)是一种慢性病,其特征为颅内压升高且病因不明,可因使人衰弱的头痛和视力丧失而导致发病。门诊护理的连续性对于监测永久性视力丧失、管理症状和限制急诊护理非常重要。这项回顾性研究的目的是确定美国一家学术医疗中心的IIH患者中与神经眼科随访预约完成情况相关的因素,以便制定基于证据的干预措施来改善依从模式。研究纳入了23名IIH患者的111次已完成或未就诊的神经眼科复诊门诊预约。采用广义估计方程模型评估预约完成状态与先前显示与预约依从性相关的因素之间的关联。预约在夏季更有可能完成(p=0.08),有头痛症状的患者更有可能完成预约(p=0.06),然而,没有一个患者因素达到统计学显著性。已完成和未就诊的预约在患者人口统计学或保险因素方面没有差异。需要进一步研究以确定IIH患者预约依从性差的风险因素,尤其是那些适合干预的因素,以改善IIH患者的护理连续性。