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Am J Ophthalmol ; 221: 48-54, 2021 01.
Article in English | MEDLINE | ID: mdl-32858028

ABSTRACT

PURPOSE: To determine the percent adherence to follow-up for patients with pediatric glaucomas seen at a tertiary care center and to elucidate risk factors. DESIGN: Retrospective cohort study. METHODS: Patients with pediatric glaucomas seen at the University of Minnesota over 8.5 years were classified as adherent, nonadherent, or lost to tertiary follow-up if they followed up within 0-30 days, between 31 and 180 days, or later than 180 days of the recommended appointment time or never, respectively. RESULTS: Of 176 patients analyzed, 95 (54%) were adherent (51% male; mean [standard deviation (SD)] age: 56.1 [59.8] months), 5 (3%) were nonadherent (20% male; mean [SD] age: 25.0 [35.8] months), and 76 (43%) were lost to tertiary follow-up (55% male; mean [SD] age: 58.9 [53.1] months). Multiple logistic regression analysis of variables that were significant in isolation revealed that only race (white: odds ratio, 3.58; 95% confidence interval, 1.42-9.05; P = .007) and distance from the eye clinic (per 50 miles: odds ratio, 0.79; 95% confidence interval, 0.67-0.92; P = .003) significantly impacted adherence. CONCLUSIONS: This is the first study of adherence to follow-up recommendations for patients with pediatric glaucomas. Percent adherence to follow-up appointments was alarmingly low, and decreased adherence was observed with non-white race and increased distance to the eye clinic. Physicians should consider these risk factors when risk-stratifying patients with pediatric glaucomas for nonadherence to follow-up. Additional studies to improve adherence through interventions that reduce biases and barriers to follow-up are needed.


Subject(s)
Aftercare/statistics & numerical data , Glaucoma/diagnosis , Health Services Accessibility/statistics & numerical data , Hydrophthalmos/diagnosis , Patient Compliance/statistics & numerical data , Ambulatory Care Facilities/statistics & numerical data , Appointments and Schedules , Child, Preschool , Continuity of Patient Care/statistics & numerical data , Female , Glaucoma/therapy , Humans , Hydrophthalmos/therapy , Infant , Intraocular Pressure/physiology , Lost to Follow-Up , Male , Medication Adherence , Retrospective Studies , Surveys and Questionnaires , Tertiary Care Centers/statistics & numerical data , Visual Acuity/physiology
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