Prevalence and Causes of Patient Dropout After Glaucoma Surgery

Abstract

ABSTRACTPurpose: To determine the prevalence of patient dropout after glaucoma surgery and reasons for the same based on patient attitudes and beliefs.Design: A hospital-based retrospective case-control study.Methods: Clinical and demographic data of patients who failed to attend follow-up within 12 months of their last scheduled appointment after glaucoma surgery were analyzed. These patients were issued recall letters and those who returned were interviewed to establish the reasons for their dropout. A structured interview was conducted to assess the educational and socioeconomic status of the patients, their knowledge and belief regarding glaucoma, their attitude towards surgery and the specific reason for their inability to follow up post-operatively. Control subjects who were regularly followed-up post-operatively were also interviewed.Results: Of 312 patients operated on from 2004–2006, only 92 (30%) patients maintained a 5-year follow-up. Of patients who dropped out, 43 patients responded to the recall letters and were interviewed along with 45 control patients. The demographic profile of those who dropped out was statistically similar to the controls; however, the controls had a significantly better awareness of glaucoma and higher monthly income (p < 0.001 and p = 0.01, respectively). Among those who dropped out, 38 (88%) believed surgery was the cure to the disease in comparison to 12 (46%) controls (p < 0.001).Conclusions: Dropout after glaucoma surgery is high among patients from lower socioeconomic strata. Misconceptions regarding surgery as a cure to glaucoma and situational factors are the most common reasons for patient dropout in this population.