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A Randomized Trial to Improve Adherence to Follow-up Eye Examinations Among People With Glaucoma.
Leiby, Benjamin E; Hegarty, Sarah E; Zhan, Tingting; Myers, Jonathan S; Katz, L Jay; Haller, Julia A; Waisbourd, Michael; Burns, Christine; Divers, Meskerem; Molineaux, Jeanne; Henderer, Jeffrey; Brodowski, Charles; Hark, Lisa A.
Afiliação
  • Leiby BE; Thomas Jefferson University, Sidney Kimmel Medical College, Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics, Philadelphia, Pennsylvania.
  • Hegarty SE; Thomas Jefferson University, Sidney Kimmel Medical College, Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics, Philadelphia, Pennsylvania.
  • Zhan T; Thomas Jefferson University, Sidney Kimmel Medical College, Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics, Philadelphia, Pennsylvania.
  • Myers JS; Wills Eye Hospital, Glaucoma Research Center, Philadelphia, Pennsylvania.
  • Katz LJ; Thomas Jefferson University, Sidney Kimmel Medical College, Department of Ophthalmology, Philadelphia, Pennsylvania.
  • Haller JA; Glaucoma Service, Wills Eye Hospital, 840 Walnut St, Ste 1110, Philadelphia PA 19107. Email: JMyers@willseye.org.
  • Waisbourd M; Wills Eye Hospital, Glaucoma Research Center, Philadelphia, Pennsylvania.
  • Burns C; Thomas Jefferson University, Sidney Kimmel Medical College, Department of Ophthalmology, Philadelphia, Pennsylvania.
  • Divers M; Thomas Jefferson University, Sidney Kimmel Medical College, Department of Ophthalmology, Philadelphia, Pennsylvania.
  • Molineaux J; Wills Eye Hospital, Office of the Ophthalmologist-in-Chief, Philadelphia, Pennsylvania.
  • Henderer J; Department of Ophthalmology, Tel Aviv Medical Center, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Israel.
  • Brodowski C; Wills Eye Hospital, Glaucoma Research Center, Philadelphia, Pennsylvania.
  • Hark LA; Wills Eye Hospital, Glaucoma Research Center, Philadelphia, Pennsylvania.
Prev Chronic Dis ; 18: E52, 2021 05 20.
Article em En | MEDLINE | ID: mdl-34014814
INTRODUCTION: Appointment nonadherence is common among people with glaucoma, making it difficult for eye care providers to monitor glaucoma progression. Our objective was to determine whether the use of patient navigators, in conjunction with social worker support, could increase adherence to recommended follow-up eye appointments. METHODS: A randomized, controlled trial evaluated the effectiveness of an intervention that used patient navigators and social workers to improve patient adherence to follow-up eye care compared with usual care. Participants with glaucoma and other eye diseases (N = 344) were identified at primary care clinics in community settings through telemedicine screening of imaging and then randomized to enhanced intervention (EI) or usual care (UC). Data on participants' visits with local ophthalmologists were collected for up to 3 years from randomization. Groups were compared for timely attendance at the first visit with the local ophthalmologist and adherence to recommended follow-up visits. RESULTS: Timely attendance at the first visit was higher for EI than UC (74.4% vs 39.0%; average relative risk [aRR] = 1.85; 95% CI, 1.51-2.28; P < .001). Rates of adherence to recommended annual follow-up during year 1 were 18.6% in the EI group and 8.1% in the usual care group (aRR = 2.08; 95% CI, 1.14-3.76; P = .02). The aRR across years 2 and 3 was 3.92 (95% CI, 1.24-12.43; P = .02). CONCLUSION: An intervention using patient navigators and social workers doubled the rate of adherence to annual recommended follow-up eye care compared with usual care in community settings, and was effective at increasing connections with local ophthalmologists. Interventions to further improve long-term adherence are needed.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Glaucoma / Telemedicina Tipo de estudo: Clinical_trials / Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies Limite: Humans Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Glaucoma / Telemedicina Tipo de estudo: Clinical_trials / Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies Limite: Humans Idioma: En Ano de publicação: 2021 Tipo de documento: Article