Follow-up Adherence and Barriers to Care for Pediatric Glaucomas at a Tertiary Care Center

Brian M Mikolajczyk, Ethan R. Greenberg, Hannah Fuher, Michael Berres, Laura L. May, Raymond G. Areaux

Research output: Contribution to journalArticlepeer-review

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 (A), nonadherent (NA), or lost to tertiary follow-up (LTTF) if they followed up within 0-30 days, between 31-180 days, or later than 180 days of the recommended appointment time or never, respectively.

RESULTS: Of 176 patients analyzed, 95 (54%) were A (51% male; mean [standard deviation (SD)] age: 56.1 [59.8] months), 5 (3%) were NA (20% male; mean [SD] age: 25.0 [35.8] months), and 76 (43%) were LTTF (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 [OR], 3.58; 95% CI, 1.42-9.05; p = 0.007) and distance from eye clinic (per 50 miles: OR, 0.79; 95% CI, 0.67-0.92; p = 0.003) 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 pediatric glaucoma patients for nonadherence to follow-up. Additional studies to improve adherence through interventions that reduce biases and barriers to follow-up are needed.

Original languageEnglish (US)
Pages (from-to)48-54
Number of pages7
JournalAmerican journal of ophthalmology
Volume221
Early online dateAug 25 2020
DOIs
StatePublished - Jan 2021

Bibliographical note

Funding Information:
All authors have completed and submitted the ICMJE form for disclosure of potential conflicts of interest. Funding/Support: This study received no funding. Financial Disclosures: The authors indicate no financial support or conflicts of interest. All authors attest that they meet the current ICMJE criteria for authorship. We want to thank the following individuals for their contributions: Wendy Elasky and Ann Holleschau for their work coordinating our study, Scott Lunos for statistical analysis, and Alana L. Grajewski, MD, for her encouragement and collaboration.

PubMed: MeSH publication types

  • Journal Article

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