Philadelphia glaucoma detection and treatment project: ocular outcomes and adherence to follow-up at a single health centre

Can J Ophthalmol. 2019 Dec;54(6):717-722. doi: 10.1016/j.jcjo.2019.03.003. Epub 2019 Sep 19.

Abstract

Objectives: To determine ocular outcomes and factors associated with adherence to ophthalmic follow-up in a medically underserved population at a single health centre in Philadelphia.

Design: Retrospective chart review.

Participants: Patients from a community glaucoma screening program.

Methods: Chart review was conducted for participants who received a complete eye examination at the Philadelphia District Health Center 5 between January 1, 2012 and May 31, 2014 within the Philadelphia Glaucoma Detection and Treatment Project. Multivariate logistic regression was used to determine factors related to ophthalmic follow-up adherence.

Results: A total of 249 participants completed an eye examination (mean age = 57.7 ± 6.9 years). Most were African American (n = 220; 88.4%); female (n = 129; 51.8%). Forty-seven participants (18.9%) received glaucoma-related diagnoses, 20 (8.0%) were prescribed ocular medication, and 26 (10.4%) underwent laser therapy. Ninety (36.1%) attended their recommended follow-up eye examination at the health centre. Glaucoma-related diagnosis (p ≤ 0.001), recommendation of a 4- to 6-week follow-up period (p < 0.001), prescribed eye drops (p < 0.001), or received laser therapy (p = 0.047) were factors most predictive of ophthalmic follow-up adherence.

Conclusions: The collaborative effort of eye care providers and health centres offers an important opportunity to detect, treat, and manage glaucoma and other ocular pathology in medically underserved communities. Having a glaucoma-related diagnosis, initiating treatment, and scheduling regular follow-up visits are the most important factors influencing adherence to follow-up eye appointments.

MeSH terms

  • Adult
  • Aftercare
  • Aged
  • Antihypertensive Agents / therapeutic use
  • Community Health Services* / methods
  • Female
  • Follow-Up Studies
  • Glaucoma, Open-Angle / diagnosis*
  • Glaucoma, Open-Angle / physiopathology
  • Glaucoma, Open-Angle / therapy*
  • Humans
  • Intraocular Pressure / physiology
  • Laser Coagulation
  • Male
  • Medically Underserved Area
  • Middle Aged
  • Patient Compliance / statistics & numerical data*
  • Philadelphia
  • Retrospective Studies
  • Tonometry, Ocular
  • Trabeculectomy
  • Visual Acuity

Substances

  • Antihypertensive Agents