Glaucoma patient-provider communication about vision quality-of-life.
Betsy Sleath, Robyn Sayner, Michelle Vitko and 6 others
PMID 27916461WHAT IT FOUND
Glaucoma visits rarely discussed vision quality of life: only 13 percent covered specific tasks, and patients usually raised them.
Providers seldom asked about night vision, reading, walking, or falls.
Key findings
01Only 13% of visits discussed one or more specific glaucoma quality-of-life domains; reading up close was discussed in 9.3% and seeing at night in 3.6%.
02Patients, not providers, usually started vision quality-of-life talk; providers asked about it in 12% of visits, and patients asked questions in 5.4%.
03African American patients were less likely to discuss glaucoma-related vision loss, less likely to make statements about vision quality of life, and less likely to be asked about it than non-African American patients.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
This was an observational study, so it shows what happened in visits, not that asking about quality of life causes better care. The authors called the study exploratory and said the results should be interpreted with care. Patients who did not participate were not compared with those enrolled, so the sample may not represent all eligible patients. Only English-speaking adults with a minimum score on a brief mental status screen were included. Coders recorded any vision quality-of-life discussion even when patients had other eye conditions, so some talk may not have been glaucoma-specific. There was only one African American physician, so physician race effects could not be tested. The visits were recorded, which may have changed how people talked.
Declared interests
The paper is listed as NIH extramural-supported. Most authors declared no conflict of interest. Dr Robin reported consulting and paid lectures for several pharmaceutical companies and stock options in Glaucos. Dr Hartnett reported consulting for Axikin Pharmaceuticals. Dr Muir reported salary support from a VA Health Services Research and Development Career Development Award.
The easy way to misread this
Do not read this as proof that asking about vision quality of life improves glaucoma care. The study observed how often it was discussed and linked that to patient traits; it did not test a communication intervention or patient outcomes.