Characteristics Associated With New Patient Appointment No-Shows at an Academic Ophthalmology Department in the United States

Chiam, Mckenzee; Kunselman, Allen R.; Chen, Michael C.

doi:10.1016/j.ajo.2021.02.020

Cited by 16 publications

(9 citation statements)

References 32 publications

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“…There was conflicting evidence over follow-up appointment adherence being associated with race and ethnicity. Six studies found that White patients were more likely to follow up with an ophthalmologist than American Indian and Alaska Native, Asian, Black, Hispanic, and Native Hawaiian and Other Pacific Islander patients and patients of unreported race; conversely, 3 studies found no significant association between race and ethnicity and follow-up adherence . Pineles et al reported that White patients were more likely to be diagnosed with eye diseases than patients of other races.…”

Section: Resultsmentioning

confidence: 99%

“…Six studies demonstrated that patients with lower income were more likely to have vision impairment, 48,50,51 have worse postsurgical outcomes, 61 and/or use eye care services less. 35,41 Seven studies reported that lower-income patients had lower adherence to both eye examinations and glaucoma medication use, 22,38,62,63 received fewer anti-vascular endothelial growth factor injections, 64 and were more likely to report having glaucoma 65 or diabetic retinopathy. 66 Regarding patients with higher income, studies found that higher income was associated with lower prevalence of myopia, 45 glaucoma, 65 and diabetic retinopathy 66 as well as an increased likelihood of receiving an eye examination.…”

Section: Incomementioning

confidence: 99%

“…Rural and underresourced inequities were evaluated in 21 studies (28%). One study by Chiam et al 22 found that increased drive time to an ophthalmology clinic was associated with no-show appointment status, and Mikolajczyk et al 23 reported that decreased distance from an ophthalmology clinic was associated with follow-up adherence. However, Wang et al 42 found that patients living greater distances from a medical center were more likely to receive an ophthalmology consultation.…”

Section: Rural and Underresourced Areasmentioning

confidence: 99%

“…Our review found associations between greater distances to clinics and decreased follow-up adherence and increased numbers of no-show appointments. 22 Although prior studies have investigated the efficacy of telemedicine in ophthalmology, research regarding implementation has been fairly limited. A systematic review examining barriers to implementation of telemedicine worldwide found significant barriers for both the patient and clinician, such as challenges to training of staff, resistance to change, and lack of internet access for patients in underresourced areas.…”

Section: Rural and Underresourced Areasmentioning

confidence: 99%

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Inequities and Research Gaps in Ophthalmology

et al. 2023

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ImportanceDeficient ophthalmologic care is costly to patients, making the identification of groups not receiving adequate care of vital importance. The current landscape of equity in ophthalmic care has yet to be thoroughly investigated and is important to ensure inclusivity and patient-centered care.ObjectiveTo perform a scoping review of the literature pertaining to health care inequities in the field of ophthalmology.Evidence ReviewA comprehensive database search using MEDLINE (via PubMed) and Ovid Embase was done in July 2022. English-language articles published from 2016 to 2021 were included and encompassed all article types except commentaries or correspondence. The search modeled the National Institutes of Health list of designated US health inequity populations, which includes income, education level, occupational status, rural and underresourced area, sex and gender, lesbian, gay, bisexual, transgender, and queer (LGBTQ) identity, and race and ethnicity. A total of 8170 abstracts and titles were screened by 2 independent investigators, and 189 studies were assessed in full text for eligibility. For inclusion, articles needed to be an ophthalmic study discussing health inequities. In a masked, duplicate fashion, 2 independent investigators screened 75 full-text studies for data extraction using a pilot-tested form. Data extraction included general publication characteristics and health inequity data based on the National Institutes of Health’s defined inequity groups.FindingsA total of 75 publications were included. Notable inequities were found among Black and Hispanic patients associated with negative ophthalmic outcomes and mixed associations regarding sex or gender. Overall, lower-income patients were more likely to have vision impairment, use eye care services less, and have lower adherence to eye examinations. No articles within our sample examined LGBTQ inequities among ophthalmology patients since the 2016 National Institutes of Health classification of sexual and gender minority populations. Substantial research gaps were observed within the ophthalmic literature pertaining to the LGBTQ community, race and ethnicity, and rural and underresourced areas.Conclusions and RelevanceThis scoping review found substantial findings associated with the LGBTQ community, race and ethnicity, and the role of telemedicine in rural and underresourced areas. Because of the importance of ophthalmic care in overall patient health, it is vital to understand the various inequities present and strive to improve the current gaps in the literature. Future studies should (1) examine barriers to clinical study and medical trainee recruitment as well as patient values and preference studies and (2) investigate the implementation of telemedicine in underresourced areas.

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Section: Resultsmentioning

confidence: 99%

Section: Incomementioning

confidence: 99%

Section: Rural and Underresourced Areasmentioning

confidence: 99%

Section: Rural and Underresourced Areasmentioning

confidence: 99%

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Inequities and Research Gaps in Ophthalmology

et al. 2023

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“…42 In other studies, patients with nAMD who had a long journey distance discontinued anti-VEGF treatment significantly more frequently than those who lived near the clinic, especially within 100 km. [43][44][45][46][47] Besides travel costs, dependence on relatives, higher age and poor visual acuity at baseline were associated with higher risk for NA. 23,36,43,48 In this study, the ABQ-IVT was used as a method for measurement of adherence and identification of possible barriers.…”

mentioning

confidence: 99%

Importance of Treatment Duration: Unmasking Barriers and Discovering the Reasons for Undertreatment of Anti-VEGF Agents in Neovascular Age-Related Macular Degeneration

Sobolewska¹,

Sabsabi²,

Ziemssen³

2021

OPTH

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Purpose: Since non-adherence (NA) to intravitreal therapy with VEGF drugs is one of the most important modifiable factors compromising treatment outcome of nAMD, the purpose of this study was to investigate the contributing factors and barriers during long-term nAMD treatment. Methods: Barriers and potential reasons for NA were prospectively measured using the Adherence Barriers Questionnaire Intravitreal Therapy (ABQ-IVT). A random sample of patients receiving intravitreal therapy was drawn based on data for different treatment periods. Three age-sex matched groups included the treatment periods of ≤30 months (group 1), between >30 months and ≤60 months (group 2), and >60 months (group 3). The occurrence of gaps between treatments and/or OCT visits was evaluated. Results: NA with gaps of >56 days after the scheduled appointment was detected in 39%, 89%, and 100% of patients in group 1, 2, and 3, respectively (groups 1 and 2 vs group 3, p < 0.001). Two or more of such gaps were observed in 6%, 72%, and 94% of patients in group 1, 2, and 3, respectively. The overall ABQ-IVT score showed corresponding differences between the groups:

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Longer Times to Delivery of Otolaryngology Care for Patients With Limited English Proficiency

Lopez

Gottlieb

Naples

2023

Otolaryngol.--head neck surg.

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ObjectiveLimited English proficiency (LEP) is known to contribute to poorer health outcomes and delays in management. However, to our knowledge, no other studies have explored the impact of LEP on delays to care within otolaryngology. This study aims to investigate the relationship between LEP and the time to delivery of otolaryngology care.MethodsWe retrospectively reviewed 1125 electronic referrals to an otolaryngologist from primary care providers at 2 health centers in the greater Boston area, between January 2015 and December 2019. Multivariable logistic regression analyses were conducted to determine if patient LEP status (preferred language non‐English and language interpreter use) has an impact on total time to appointment (TTTA).ResultsPatients with non‐English preferred languages were 2.6 times more likely to experience extended TTTA (odds ratio [OR] = 2.61, 95% confidence interval [CI] = 1.99‐3.42, p < .001) relative to English‐speaking patients. Patients who required interpreter use were 2.4 times more likely to experience extended TTTA (OR = 2.42, 95% CI = 1.84‐3.18, p < .001) relative to patients who did not require an interpreter. There was no difference in age, sex, insurance type, education level, or marital status. TTTA did not vary by diagnosis category (p = .09).DiscussionLEP is an important factor that influences the time to appointment in our cohort. Notably, the impact of LEP on appointment wait times was independent of diagnosis.Implications for PracticeClinicians should recognize LEP as a factor that can impact the overall delivery of care in otolaryngology. Specifically, mechanisms to streamline care for LEP patients should be considered.

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Characteristics Associated With New Patient Appointment No-Shows at an Academic Ophthalmology Department in the United States

Cited by 16 publications

References 32 publications

Inequities and Research Gaps in Ophthalmology

Inequities and Research Gaps in Ophthalmology

Importance of Treatment Duration: Unmasking Barriers and Discovering the Reasons for Undertreatment of Anti-VEGF Agents in Neovascular Age-Related Macular Degeneration

Longer Times to Delivery of Otolaryngology Care for Patients With Limited English Proficiency

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