Agreement Between Self-Reported Co-morbidity of Visually Impaired Older Patients and Reports from their General Practitioners

Abstract

Purpose: In visually impaired older patients, it is unclear which coexisting conditions patients suffer from and whether all co-existing conditions are reported by the patient. Our purpose was to present the level of agreement between patients' and their general practitioners' co-morbidity reports. Methods: Analyses were performed on data from an observational study among 296 visually impaired older patients. Agreement between patients and 165 general practitioners was obtained from twelve (chronic) condition categories. Cohen's Kappa was used to assess the level of agreement. Results: Patients reported a median number of co-existing conditions of 1 (range: 0-4) and general practitioners 3 (range: 0-7). Agreement was 'very good' for diabetes (Kappa 0.82; 95% CI [0.73;0.92]) and 'moderate' for heart conditions (Kappa 0.48; 95% CI [0.33;0.62]) and COPD or asthma (Kappa 0.60; 95% CI [0.45;0.75]). Kappa values were 'fair' (0.29 to 0.34) for cancer, musculo-skeletal conditions, hearing impairments and stroke, and 'poor' (−0.01 to 0.18) for psychological problems, chronic skin problems, gastrointestinal conditions, chronic allergies, thyroid gland conditions and hypertension. Conclusions: Agreement between patients and their general practitioners differed per condition, but was for most conditions poor to fair. Rehabilitation services, ophthalmologists and rehabilitation researchers should be aware that patients often under report co-morbidity. We recommend using medical charts or asking visually impaired older patients for co-existing conditions using pre-structured questionnaires in order to obtain a more complete view of the patient's health status.

Assessing visual activities of daily living in the visually impaired

“…The limitations of self‐report are further highlighted in this study by the lack of concordance between subjects’ initial self‐reported use of LVAs for the ADL tasks and their actual use of LVAs in the assessed tasks (). Such limited agreement has also been seen in other areas of low vision, such as the self‐reporting of co‐morbidities (van Nispen et al. , 2008).…”

Factors Influencing Self-reported Vision-Related Activity Limitation in the Visually Impaired

“…A structured face-to-face interview elicited key demographics including age, gender, primary cause of visual impairment, and the length of time since ocular diagnosis of each eye, living arrangements, and education. The presence of any co-morbidity from a list of 12 common medical conditions 23 and details of any prescribed medications were recorded and used to represent general health. Focimetry of any current spectacles was undertaken and recorded.…”

Co-morbidity and visual acuity are risk factors for health-related quality of life decline: five-month follow-up EQ-5D data of visually impaired older patients

“…For example, Brody et al found that 78% of older patients reported to have at least one other condition in addition to AMD. In our own patient population of visually-impaired older adults with a variety of eye conditions, 75% reported to have other conditions in addition to their eye disease [ 10 ]. Langelaan et al reported that different chronic conditions have a different impact on health-related QOL [ 11 ].…”