Glaucoma Patients' Trust in the Physician

Kelly W. Muir,Paul P. Lee,Leon W. Herndon,Pratap Challa,Sandra S. Stinnett,Cecilia Santiago-Turla,R. Rand Allingham

doi:10.1155/2009/476726

Abstract

Objectives. To describe glaucoma patients' trust in the physician and to test the hypothesis that increased interpersonal trust is associated with increased medication adherence. Methods. One hundred ninety-five subjects with open-angle glaucoma seen by multiple glaucoma subspecialists participated in a cross-sectional patient survey and concomitant chart review which included a test of health literacy and the Trust in Physician Scale (TPS), a scale from 1–100, with 100 indicating greatest trust. Charts were reviewed for visual acuity and visual field results. Subjects' pharmacies were contacted to ascertain medication refill rates over the preceding six months. Results. TPS scores ranged from 57.5 to 100, 78.7 ± 8.4 (mean ± SD,) median 75.0. When age, race, gender, baseline visual acuity and visual field status, education level, and literacy status were considered, only race was associated with TPS. Caucasians expressed slightly higher levels of trust (n = 108; TPS 80.1 ± 8.2) than non-Caucasians, (n = 87 (82 Africans Americans); TPS 77.1 ± 8.4; P = .012). TPS score was not associated with refill rates (P = .190). Conclusions. Trust in physician is generally high in this group of glaucoma patients but varies slightly by race. Trust in physician was not associated with glaucoma medication adherence in this tertiary care population.

Highlights

Greater patient trust in his or her physician is associated with greater patient satisfaction [1] and decreased likelihood of changing physicians [2]
With these thoughts in mind, we sought to characterize the level of trust in the glaucoma patientphysician relationship, assess the contribution of potential explanatory variables such age, race, gender, and health literacy, and test the hypothesis that greater trust in physician is associated with greater medication adherence
The survey included questions relating to demographic data, the Minimental State Exam (MMSE), the Rapid Assessment of Adult Literacy in Medicine (REALM; a word recognition test of functional health literacy) [20], and the Trust in Physician Scale (TPS)

Summary

Introduction

Greater patient trust in his or her physician is associated with greater patient satisfaction [1] and decreased likelihood of changing physicians [2]. It has been suggested that elements of the patient-physician relationship may play a role in patients’ adherence to glaucoma treatment [18], and, Friedman and colleagues found that patients who exhibited a more passive learning style were less likely to adhere to their medications [15]. With these thoughts in mind, we sought to characterize the level of trust in the glaucoma patientphysician relationship, assess the contribution of potential explanatory variables such age, race, gender, and health literacy, and test the hypothesis that greater trust in physician is associated with greater medication adherence

Objectives

Methods

Results

Conclusion