Engagement in the Michigan Screening and Intervention for Glaucoma and Eye Health through Telemedicine Program

Elam, Angela R.; Mobolaji, Ire; Flaharty, Kathryn; Niziol, Leslie M.; Woodward, Maria A.; Zhang, Jason; Musch, David C.; Johnson, Leroy; Kershaw, Martha; Bicket, Amanda K.; Saaddine, Jinan B.; John, Denise; Newman-Casey, Paula Anne

doi:10.1016/j.ogla.2022.10.006

Cited by 6 publications

(7 citation statements)

References 23 publications

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“…26,27 Although controversy exists regarding the value of community-based glaucoma screening programs, [28][29][30] multiple studies have shown that these programs can significantly increase patient retention rates, generate new revenue streams, and improve patient outcomes when utilized effectively. [31][32][33] Implementing strategies such as employing diverse health care teams, increasing representation in advertisements and educational materials, and partnering with community advisory boards to target the needs of the local community can help to foster trust in health care among these groups and lead to greater health care engagement. 31 As such, we argue it may be indicated in all diverse communities-but especially important in predominantly Black/African American communities-to utilize these programs to promote earlier detection of glaucoma and encourage regular follow-up care to mitigate disease progression.…”

Section: Discussionmentioning

confidence: 99%

“…[31][32][33] Implementing strategies such as employing diverse health care teams, increasing representation in advertisements and educational materials, and partnering with community advisory boards to target the needs of the local community can help to foster trust in health care among these groups and lead to greater health care engagement. 31 As such, we argue it may be indicated in all diverse communities-but especially important in predominantly Black/African American communities-to utilize these programs to promote earlier detection of glaucoma and encourage regular follow-up care to mitigate disease progression. In addition, artificial intelligence and telemedicine may also offer opportunities to expand access to eyecare by making glaucoma screening more accurate, efficient, accessible, and less costly to ethnic minority groups.…”

Section: Discussionmentioning

confidence: 99%

“…Likewise, automated messaging systems could utilize patient disease severity to identify those patients requiring more frequent eye exams and send reminders as needed, which can improve visit and medication adherence in at-risk populations. 31 In this way, data interoperability could serve as a bridge for outreach to more patients with more severe diseases and can help narrow disparities.…”

Section: Discussionmentioning

confidence: 99%

“…Although controversy exists regarding the value of community-based glaucoma screening programs, 28–30 multiple studies have shown that these programs can significantly increase patient retention rates, generate new revenue streams, and improve patient outcomes when utilized effectively 31–33 . Implementing strategies such as employing diverse health care teams, increasing representation in advertisements and educational materials, and partnering with community advisory boards to target the needs of the local community can help to foster trust in health care among these groups and lead to greater health care engagement 31 .…”

Section: Discussionmentioning

confidence: 99%

“…This could lead to decision support mechanisms, which would provide an automated suggested stage of disease, removing the burden on clinicians and standardizing coding of disease severity. Likewise, automated messaging systems could utilize patient disease severity to identify those patients requiring more frequent eye exams and send reminders as needed, which can improve visit and medication adherence in at-risk populations 31 . In this way, data interoperability could serve as a bridge for outreach to more patients with more severe diseases and can help narrow disparities.…”

Section: Discussionmentioning

confidence: 99%

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Racial, Ethnic, and Socioeconomic Disparities in Glaucoma Onset and Severity in a Diverse Nationwide Cohort in the United States

Acuff,

Radha Saseendrakumar,

et al. 2023

Journal of Glaucoma

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Precis: Racial/ethnic minorities are diagnosed with glaucoma at younger ages, and Blacks are more likely to be diagnosed with moderate-to-severe glaucoma. Additionally, we highlight a gap in the use of diagnosis codes. Purpose: To analyze patterns of diagnosis coding usage and validate epidemiologic patterns of glaucoma onset and severity among primary glaucoma patients within the National Institutes of Health All of Us database. Patients and Methods: We used ICD diagnosis codes to build 4 cohorts of patients with mild, moderate, severe, and unspecified stage glaucoma (N=2982). Descriptive analyses were stratified by disease stage, and mean age at diagnosis was compared across racial and ethnic groups. Multivariable ordinal regression was used to examine risk factors for increasing glaucoma severity. Results: Of 2982 participants, 1714 (57%) had unspecified severity staging. Black/African Americans and other races were diagnosed with glaucoma at significantly younger ages compared to Whites (means 60 and 60 vs. 66 years; P<0.001). Hispanic/Latino participants also had an earlier mean age of diagnosis (61 vs. 65 years; P=0.001). Black/African Americans had higher odds of more severe glaucoma (OR: 2.20, 95% CI: 1.62–3.30; P<0.001) than Whites when adjusting for socioeconomic characteristics. Conclusions: Black, Hispanic/Latino, and other minority participants are diagnosed with glaucoma at younger ages, and Blacks are more likely to be diagnosed with moderate-to-severe glaucoma. These findings validate prior population-based studies. Furthermore, we observed a gap in the use of diagnosis codes, as only 43% of participants had a specified severity stage in this national cohort. This may have implications for large-scale observational research concerning glaucoma severity as electronic health records and claims databases typically lack other measures of disease progression, such as imaging and visual field data.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Racial, Ethnic, and Socioeconomic Disparities in Glaucoma Onset and Severity in a Diverse Nationwide Cohort in the United States

Acuff,

Radha Saseendrakumar,

et al. 2023

Journal of Glaucoma

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A Screening Strategy to Mitigate Vision Impairment by Engaging Adults Who Underuse Eye Care Services

Sherman,

Niziol,

Hicks

et al. 2024

JAMA Ophthalmol

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ImportanceUnderuse of eye care services leads to underdiagnosed and undertreated eye disease.ObjectiveTo assess the reasons for underuse of eye care and whether a novel, free eye disease screening program is engaging adults who are both at high risk of eye disease and were underusing eye care services.Design, Setting, and ParticipantsIn a population-based cross-sectional study, adult participants from the first year of the Michigan Screening and Intervention for Glaucoma and Eye Health Through Telemedicine (MI-SIGHT) Program were included. The participants were recruited from primary care clinics serving 2 low-income communities. Recruitment occurred between June 28, 2020 and June 27, 2021 at the free clinic, and between January 27, 2021 and January 26, 2022 at a federally qualified health clinic. Data were analyzed from December 7, 2022, to May 29, 2024. Participants received comprehensive eye disease screening and completed surveys assessing health and prior eye care use. Risk factors for eye disease included age 65 years and older, diabetes, personal or family history of eye disease, and self-identifying as Black or African American individuals who were aged 50 years or older. Underuse of eye care was defined as no eye examination in 2 or more years.Main Outcomes and MeasuresPercentage of participants who were at high risk of eye disease and underused eye care services before accessing this program.ResultsA total of 1171 MI-SIGHT participants were a mean (SD) age of 55 (14.5) years; 437 (38%) identified as male; 591 (54%) self-identified as Black or African American, 101 (10%) as Hispanic or Latino, and 371 (34%) as White; 492 (43%) had high school education or less, and 696 (70%) reported an annual household income of less than $30 000. Characteristics of participants reporting not having had an eye examination in 2 years or more included 23% (n = 151) of participants 65 years and over, 33% (n = 214) of participants who self-reported diabetes, 25% (n = 130) of participants reporting a family history of glaucoma, 3% (n = 14) of those with self-reported glaucoma; and 33% (n = 202) of Black or African-American participants aged 50 years and older. In participants who reported not having had an eye examination in 2 or more years, 21% (n = 137) screened positive for glaucoma, 20% (n = 129) for cataract, 6% (n = 38) for diabetic retinopathy, and 1% (n = 9) for age-related macular degeneration. Reported reasons for why participants had not had an eye examination included no insurance (175 of 627 [28%]), no reason to go (no problem) (135 of 627 [22%]), and cost of eye examination (101 of 627 [16%]).Conclusions and RelevanceThe findings of this study suggest that placing eye disease detection programs in primary care clinics in underserved areas may improve eye disease detection and treatment, possibly mitigating needless vision loss in the US.

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Research and scholarly methods: Community‐engaged research

Moczygemba,

Singh,

Baffoe

2023

J Am Coll Clin Pharm

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Community‐engaged research (CER) is a collaborative approach used by health services researchers to integrate the voice of community stakeholders in research design to increase the relevance and impact of research in advancing health outcomes. CER is guided by principles such as leveraging strengths and resources of a community, ensuring research is mutually beneficial for all partners, facilitating co‐learning among all partners, disseminating findings to all partners, and committing long term to a community. The level of community engagement can range on a continuum from outreach, consultations, and community‐academic partnerships to community‐based participatory research depending on the type and extent of community stakeholder involvement. Given pharmacists’ accessibility to the public and role as the medication expert across the health care continuum, pharmacist researchers can use CER to authentically engage communities to better understand medication‐related needs and design community‐informed interventions to optimize medication outcomes. The purpose of this paper is to provide a practical overview of CER for pharmacist researchers by: 1) introducing the CER continuum and describing how CER principles can be used before, during, and after a study, 2) describing practical considerations for conducting CER, and 3) discussing two examples of CER in improving medication‐related outcomes in health services research.This article is protected by copyright. All rights reserved.

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Engagement in the Michigan Screening and Intervention for Glaucoma and Eye Health through Telemedicine Program

Cited by 6 publications

References 23 publications

Racial, Ethnic, and Socioeconomic Disparities in Glaucoma Onset and Severity in a Diverse Nationwide Cohort in the United States

Racial, Ethnic, and Socioeconomic Disparities in Glaucoma Onset and Severity in a Diverse Nationwide Cohort in the United States

A Screening Strategy to Mitigate Vision Impairment by Engaging Adults Who Underuse Eye Care Services

Research and scholarly methods: Community‐engaged research

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