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African American patient-provider communication about glaucoma vision quality-of-life

Eye volume 38, pages 343–348 (2024)Cite this article

Subjects

Abstract

Background/objectives

Little is known about African American patient-provider communication about glaucoma-related quality-of-life. The objectives of this study were to: (a) examine associations between patient socio-demographics and vision quality-of-life, (b) describe the extent to which eye care providers and patients discuss glaucoma-related quality-of-life, and (c) examine associations between patient and provider characteristics, whether the patient was in the intervention or usual care group, and whether the patient and provider discuss one or more glaucoma-related quality-of-life domains.

Methods

Adult African American patients with glaucoma who reported non-adherence to glaucoma medications were enrolled from three sites. Patients completed a vision quality-of-life VFQ-25 assessment. Patients were randomized into intervention and control groups with intervention group members receiving a glaucoma question prompt list and watching a video before a provider visit. Audio recordings from these visits were transcribed and assessed for glaucoma-related quality-of-life discussions.

Results

One hundred and eighty-nine patients were enrolled. Glaucoma-related quality-of-life was discussed during 12.3% of visits (N = 23). Patients initiated discussion 56.5% (N = 13) of the time and providers 43.5% (N = 10) of the time. Patients with worse health literacy (p < 0.001), more depressive symptoms (p < 0.05), and more severe glaucoma (p < 0.001) were significantly more likely to have worse vision-related quality-of-life. Glaucoma-related quality-of-life was significantly more likely to be discussed when African American patients saw African American providers (p < 0.05).

Conclusion

Patients and providers rarely discussed the patient’s glaucoma-related quality-of-life. The intervention did not significantly increase communication about glaucoma-related quality-of-life. Residency programs should consider enhancing training regarding discussing patients’ quality-of-life.

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Data availability

De-identified individual data that supports the results will be shared following publication provided the investigator who proposes to use the data has approval from an Institutional Review Board (IRB), Independent Ethics Committee (IEC), or Research Ethics Board (REB), as applicable, and executes a data use/sharing agreement with UNC Chapel Hill.

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Acknowledgements

This work was supported by a grant from the Agency for Healthcare Research and Quality, Rockville MD (R01 HS 025370). The funding organization had no role in the design or conduct of this research. ClinicalTrials.gov Identifier: NCT03657147.

Author information

Authors and Affiliations

  1. Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Betsy Sleath, Bethany Beznos, Delesha M. Carpenter & Nacire Garcia

  2. Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Betsy Sleath

  3. Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Donald L. Budenz

  4. Department of Ophthalmology, School of Medicine, Duke University, Durham, NC, USA

    Kelly W. Muir

  5. Durham VA Medical Center, Health Services Research and Development, Durham, NC, USA

    Kelly W. Muir

  6. Physician CEO, Precision Eye Care, Baltimore, MD, USA

    Maria S. Romero

  7. Alexor, LLC, Durham, NC, USA

    Charles Lee

  8. Southern New Hampshire University, Manchester, NH, USA

    Gail Tudor

  9. Wilmer Institute, Johns Hopkins University, Baltimore, MD, USA

    Alan L. Robin

  10. American Glaucoma Society, San Francisco, CA, USA

    Alan L. Robin

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Contributions

Conception and design: BS, DMC, DLB, KWM, GT, NG, ALR, CL. Analysis and interpretation: BB, BS, GT. Data collection: BS, DMC, DLB, KWM, MSR, NG, ALR. Obtained funding: BS, DMC, DLB, KWM, GT, ALR, CL. Overall responsibility: BS, DLB, KWM, ALR, GT.

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Correspondence to Betsy Sleath.

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Sleath, B., Beznos, B., Carpenter, D.M. et al. African American patient-provider communication about glaucoma vision quality-of-life. Eye 38, 343–348 (2024). https://doi.org/10.1038/s41433-023-02693-8

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