Kosoko O, Quigley H A, Vitale S, Enger C, Kerrigan L, Tielsch J M
Division of Ophthalmology, Howard University School of Medicine, Washington, DC, USA.
Ophthalmology. 1998 Nov;105(11):2105-11. doi: 10.1016/S0161-6420(98)91134-4.
This study aimed to identify factors associated with compliance with glaucoma follow-up visits.
Computer records of a university residents' eye clinic were reviewed to identify a random sample of all persons who had an examination with International Classification of Disease (ICD) 9 coding (ICD9) for glaucoma suspect or glaucoma during a 2-year period (1991-1993) to undergo telephone interview.
Those who were seen at least every 6 months regardless of earlier return instructions were defined as compliant with follow-up (controls, n = 362). Those who had any lapse between visits of longer than 6 months were defined as noncompliant (cases, n = 362).
Interviews were completed for 196 cases and 242 controls. Noncompliant persons were significantly more likely to be suspects for glaucoma rather than to have definite glaucoma and to be dissatisfied with waiting time in the clinic (29.1% vs. 17.8%, P < 0.005) and to state that they did not take their glaucoma medications as prescribed (25.4% vs. 13.4%, P < 0.004). They also were less likely to have been prescribed eyedrop medication. A high percentage of both patients and controls knew that glaucoma can lead to blindness (85.2% and 88.4%, respectively). The most common reasons patients gave for not keeping follow-up visits were the perception that their eye problem was "not serious enough," the cost of examinations, and that the doctor did not tell them to come back.
Compliance with follow-up visits for glaucoma is associated with markers for early disease. Attempts to improve compliance might focus on improved communication of the seriousness of the disease and improvements in clinic waiting time.
本研究旨在确定与青光眼随访依从性相关的因素。
回顾了一所大学居民眼科诊所的计算机记录，以确定在1991年至1993年的2年期间接受过青光眼疑似病例或青光眼的国际疾病分类（ICD）9编码（ICD9）检查的所有人员的随机样本，以便进行电话访谈。
那些无论之前的复诊指示如何，至少每6个月就诊一次的人被定义为随访依从者（对照组，n = 362）。那些就诊间隔超过6个月的人被定义为不依从者（病例组，n = 362）。
完成了对196例病例和242例对照的访谈。不依从者更有可能是青光眼疑似患者而非确诊青光眼患者，并且对诊所的等待时间不满意（29.1%对17.8%，P < 0.005），并表示他们没有按规定服用青光眼药物（25.4%对13.4%，P < 0.004）。他们也较少被开眼药水药物。患者和对照组中很大一部分人都知道青光眼会导致失明（分别为85.2%和88.4%）。患者不进行随访的最常见原因是认为他们的眼部问题“不够严重”、检查费用以及医生没有告知他们回来复诊。
青光眼随访的依从性与早期疾病的标志物相关。提高依从性的努力可能集中在改善对疾病严重性的沟通以及改善诊所等待时间上。
