A Previsit Intervention’s Influence on Glaucoma Topics Discussed between Black Patients and Providers

Abstract

The objectives of this study were to conduct a randomized controlled trial testing the effectiveness of a previsit glaucoma video/question prompt list intervention, and to examine the impact on how often providers educate Black patients about glaucoma and glaucoma medication topics during visits. A randomized controlled trial of a glaucoma question prompt list/video intervention. Black patients with a diagnosis of glaucoma who are taking 1 or more glaucoma medications and report being nonadherent. One hundred eighty-nine Black patients with glaucoma were enrolled and assigned to either a usual care or an intervention group where they watched a video emphasizing the importance of asking questions and received a glaucoma question prompt list to complete before clinic visits. Visits were audio-taped and patients were interviewed after visits. Whether the provider educates about different glaucoma and glaucoma medication topics. Patients in the intervention group were significantly more likely to ask providers 1 or more questions about glaucoma and its treatment. Providers were significantly more likely to educate intervention patients about their diagnosis (P= 0.001), intraocular pressure (P= 0.03), the likelihood of the need for long-term therapy (P= 0.001), and the physical changes associated with glaucoma (P= 0.001) than usual-care patients. Providers were also significantly more likely to educate intervention patients about the purpose of their medications (P= 0.03) and side effects (P= 0.001) than usual-care patients. Providers only educated 29% of patients about adherence (33% of intervention group patients and 25% of usual-care patients). Few providers educated patients about barriers and fears/concerns in using glaucoma medications, the cost of medications and insurance coverage, how to administer eye drops, and nasolacrimal occlusion. The intervention significantly increased provider education about many glaucoma and glaucoma medication topics. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.