TY - JOUR
T1 - Follow-up Adherence and Barriers to Care for Pediatric Glaucomas at a Tertiary Care Center
AU - Mikolajczyk, Brian
AU - Greenberg, Ethan R.
AU - Fuher, Hannah
AU - Berres, Michael
AU - May, Laura L.
AU - Areaux, Raymond G.
N1 - Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2021/1
Y1 - 2021/1
N2 - 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.
AB - 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.
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U2 - 10.1016/j.ajo.2020.08.033
DO - 10.1016/j.ajo.2020.08.033
M3 - Article
C2 - 32858028
AN - SCOPUS:85095459151
SN - 0002-9394
VL - 221
SP - 48
EP - 54
JO - American journal of ophthalmology
JF - American journal of ophthalmology
ER -