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Some patients unaware of having glaucoma despite long-term treatment
Nearly 9% of Americans may not know or deny having glaucoma in spite of long-term IOP-lowering treatment, according to a study.
These conclusions were based on the results of the NHANES survey, conducted every 2 years on a stratified sample of civilian U.S. population.
During the 2005-2006 and 2007-2008 cycles, patients were asked whether they were taking prescription medicines, and to those who reported being on IOP-lowering medications the question, “Have you ever been told by an eye doctor that you have glaucoma, sometimes called high pressure, in your eyes?” was asked.
Surprisingly, of the 160 (2.3%) participants who reported taking prescription IOP-lowering medications, 15 (11%) denied the diagnosis of glaucoma or high eye pressure. Awareness of glaucoma diagnosis was higher among patients taking a greater number of medications.
After correction for weighting, 153,204 (8.8%) Americans on long-term glaucoma therapy may not know, or may deny, that they have glaucoma or ocular hypertension.
“Poor communication and patient disease understanding persist in this setting,” the authors wrote.
They concluded that there is room for significant improvement in the education of patients.
“Clinicians may use this information to identify patients that would benefit from more education to improve disease awareness and, potentially, adherence,” they wrote. – by Michela Cimberle
Disclosure: The authors reported no relevant financial disclosures.
Perspective
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About 9% of patients receiving IOP-lowering treatment deny having glaucoma. While there can be debate as to how the question was presented and whether it over- or underestimated the true number, the fact remains that the number is too high. Clearly, patients need better glaucoma education, and health providers may need more training on how to effectively communicate. Perhaps other methods such as follow-up calls (emails/texts) from staff or doctors might combat the initial information overload that surely follows a glaucoma diagnosis.
In my practice we see a lot of patients for second opinions on glaucoma. I generally find that while the testing and treatment implemented by doctors were reasonable, the lack of adequate counseling (to the patient’s satisfaction) results not only in a poor understanding of glaucoma but also creates a perception of incompetence and doubt as to the proper diagnosis.
When patients are unsure of why they are taking a daily medication, they might forgo the second opinion and simply discontinue treatment. This highlights the fact that even with an extensive diagnostic and therapeutic arsenal, the most important factor in preserving vision for glaucoma patients may still be proper counseling.