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Optom Vis Sci. 2014 May;91(5):549-55. doi: 10.1097/OPX.0000000000000244.

Provider use of collaborative goal setting with glaucoma patients.

Author information

  • 1*PhD †PhD candidate ‡PharmD §PhD, MSPH ∥MD University of North Carolina Eshelman School of Pharmacy (BS, CS, SJB, RS, DMC), Cecil G. Sheps Center for Health Services Research (BS), University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Ophthalmology, School of Medicine, Duke University, Durham, North Carolina (KWM); Durham VA Medical Center, Health Services Research and Development, Durham, North Carolina (KWM); Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah (MEH); and Department of International Health, Bloomberg School of Public Health, and Department of Ophthalmology, School of Medicine, Johns Hopkins University, Baltimore, Maryland (ALR).

Abstract

PURPOSE:

The purpose of this preliminary study was to describe the extent to which providers used collaborative goal setting and individualized assessment with patients who were newly prescribed glaucoma medications.

METHODS:

English-speaking glaucoma suspect patients from six ophthalmology clinics who were newly prescribed glaucoma medications had their medical visits videotaped and were interviewed after the visits. The videotapes were transcribed and coded to examine provider use of collaborative goal setting and individualized assessment.

RESULTS:

Fifty-one patients seeing 12 ophthalmologists participated. Providers gave patients glaucoma treatment options during 37% of the visits; only five providers gave patients treatment options Providers asked for patient treatment preferences in less than 20% of the visits; only two providers asked for patient treatment preferences. Providers were significantly more likely to ask African American patients for their preferences or ideas concerning treatment than non-African American patients (Pearson χ² = 4.1, p = 0.04). Providers were also significantly more likely to ask African American patients about their confidence in using glaucoma medication regularly than non-African American patients (Pearson χ² = 8.2, p = 0.004). Providers asked about patient views about glaucoma in less than 20% of the visits; five providers asked patients their views on glaucoma and its treatment. Providers were significantly more likely to ask African American patients about their views on glaucoma than non-African American patients (Pearson χ² = 5.62, p = 0.02).

CONCLUSIONS:

Eye care providers often did not use collaborative goal setting or conduct individualized assessments of patient views on glaucoma when prescribing treatment for the first time.

PMID:
24705480
[PubMed - indexed for MEDLINE]
PMCID:
PMC4005354
[Available on 2015/5/1]
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