PHS48 - Baseline Health Utility Scores in Subjects with Suspected Ocular Disease: An Interim Analysis of the Philadelphia Telemedicine Glaucoma Detection and Follow-Up Study

Abstract

The Philadelphia Telemedicine Glaucoma Detection and Follow-up Study is a CDC-funded prospective randomized controlled trial comparing a social worker intervention (enhanced intervention, EI) to address individual and systemic barriers to ophthalmology care versus usual care (UC). The study investigates the effect of EI on adherence to recommended follow-up eyecare in underserved Philadelphia communities. Study objectives include determining incremental cost-effectiveness of EI versus UC using health utilities derived from the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25). Objective of this analysis was to assess differences in baseline utility by demographics. Baseline demographics and NEI-VFQ-25 responses were collected for subjects randomized into the study. Demographics were assessed using descriptive statistics, and baseline utility scores (VFQ-UI) were derived from NEI-VFQ-25 responses using a validated algorithm. T-tests and ANOVA were used to assess statistical significance of differences between mean VFQ-UI by gender, race, ethnicity, marital status, and diabetic history. The sample comprised 340 subjects, n=171 randomized to EI and n=169 randomized UC. Mean age of the entire sample was 60.65 years (SD ±11.03), 59.1% were female, 65.0% were African American, and 55.9% reported history of diabetes. Mean sample VFQ-UI was 0.864 (SD ±0.111); mean EI VFQ-UI was 0.866 (SD: ±0.112) versus 0.862 (SD ±0.111) for UC. VFQ-UI was not statistically different by study group (p=0.790). No statistical differences were identified in the mean reported VFQ-UI by gender (p=0.215) or diabetes status (p=0.604). Race, ethnicity, and marital status significantly impacted VFQ-UI (p= <0.001, 0.005, 0.009, respectively). Mean VFQ-UI is generally high at baseline and did not statistically differ by study group; however, statistically significant differences were seen by race, ethnicity, and marital status, suggesting that changes in utility during the clinical trial should be measured for relevant subgroups. Future work entails evaluating change in VFQ-UI at 18 and 36 months.