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Patient understanding of OHT, glaucoma diagnosis helps outcomes
A study published in the British Journal of Ophthalmology concluded that patients with newly diagnosed primary open-angle glaucoma scored marginally better on an illness perception questionnaire on items relating to impact on life in general, experience of symptoms and understanding of their condition than those diagnosed more than 2 years ago.
It was also revealed that patients who lived with their diagnosis for more than 2 years had an improved understanding that their condition would be long-term.
According to the study authors, a patient’s perceptions, feeling or beliefs regarding their diagnosis can have a positive or negative effect on coping behaviors, treatment adherence and clinical outcomes. This study aimed to measure disease perception in patients with primary open-angle glaucoma (POAG) and ocular hypertension.
Researchers recruited 58 patients at their first clinical visits after being diagnosed with POAG and ocular hypertension (OHT). Then, researchers identified 58 other patients, related by their age, disease severity and vision loss, who had been living with their diagnosis for more than 2 years.
All patients in the newly diagnosed group and 2+ years diagnosis group took the Brief Illness Perception Questionnaire (BIPQ), EQ5D general health measure and type D personality scale.
According to the study, the average scores on the BIPQ were similar for the newly diagnosed and 2+ years groups of patients with POAG or OHT.
Using the EQ5D test to asses general health and DS14 for personality type, researchers corrected the study analysis for these variables and determined that newly diagnosed scored marginally better on BIPQ items relating to impact on life, experience of symptoms and understanding of their condition.
Researchers stated that while disease perception was similar between POAG patients and OHT patients, those with OHT may benefit the most from an early intervention, highlighting their better prognosis compared to POAG. – by Scott Buzby
Disclosure: McDonald reported no relevant financial disclosures. Please see full study for all other authors’ disclosures.
Perspective
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Seasoned health care providers understand that different patients experience the same diagnosis or condition very differently. In the old days we might withhold information from patients as to not cause them distress. While that may be unethical by today’s standards, there was some truth (supported by current research) to the belief that the diagnosis is perhaps equally or more impactful to quality of life than the condition. A modern approach involves giving as much information as possible so the patient is soothed with knowledge rather than ignorance. Education can also mitigate the negative impact of the new diagnosis and set the patient on the best management course.
Miscommunication is part of human interaction, but that doesn’t absolve us of our responsibility as health care providers to do our level best to educate our patients. Most of the second opinions I see are sought due to poor communication by the doctor rather than medical errors or misdiagnosis. That is important for us to remember because, like the patient’s interpretation of a diagnosis, perception is reality when it comes to their assessment of our competence. The best glaucoma care requires us to walk the fine line between unnecessarily upsetting and inadequately informing our patients.