The purpose was to identify factors associated with older glaucoma patients’ knowledge of, perceptions of, and predispositions for telemedicine use.
Established patients age 60 years and above with a diagnosis of primary open-angle glaucoma, glaucoma suspect, or ocular hypertension followed by a glaucoma fellowship-trained ophthalmologist were enrolled in the study at an academic, urban, tertiary referral eye clinic. Enrolled patients were administered a Life Space Questionnaire (LSQ), scored 0 to 9, and Preferences for Telemedicine Questionnaire (PTQ), a Likert scale validated tool. χ2 testing analyzed PTQ responses by age, race, education, employment status, LSQ score, and distance traveled from home address to clinic. A Mann-Whitney U test was used to compare PTQ responses by visual field index and visual acuity for the better and worse eye.
Of 110 patients enrolled, 71% of patients agreed or were neutral to receiving telediagnosis and 74% of patients agreed or were neutral to receiving teleintervention. Patients aged 60 to 69 years compared with those 70 and above had significantly greater knowledge about types of telemedicine: telediagnosis (53% vs. 31%, P=0.02), teleintervention (49% vs. 24%, P=0.006), teletriage (80% vs. 47%, P=0.0004), and telemonitoring (55% vs. 27%, P=0.003). Patients of European descent had significantly more knowledge about teletriage compared with those of non-European descent (72% vs. 53%, P=0.04). Patients with more education (>high school) compared with those with less education (≤high school) had more knowledge about telemedicine (39% vs. 16%, P=0.007) and all the uses of it: telediagnosis (61% vs. 45%, P<0.001), teleintervention (54% vs. 14%, P<0.001), teletriage (86% vs. 35%, P<0.001), and telemonitoring (59% vs. 18%, P=0.001). Patients with a LSQ score ≥6, meaning they traveled a greater distance from home in the previous 3 days, displayed significantly more knowledge about telediagnosis (49% vs. 25%, P=0.02), teleintervention (43% vs. 19%, P=0.01), and telemonitoring (47% vs. 25%, P=0.03) than those with an LSQ<6. Responses to the PTQ were not significantly different by distance traveled.
Knowledge of telemedicine was variable but between one third and one half of patients had favorable attitudes toward using telemedicine for glaucoma care.
Departments of *Ophthalmology and Visual Sciences, School of Medicine
†Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
Supported by a grant from the National Institute of Aging (NIH/NIA P30 AG022838) and a National Eye Institute grant (NIH/NEI 1K23EY025724-01A1), with supplemental support from the EyeSight Foundation of Alabama, Birmingham, AL, and Research to Prevent Blindness, New York, NY.
Disclosure: The authors declare no conflict of interest.
Reprints: Lindsay A. Rhodes, MD, Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham, EFH 601, 1720 2nd Avenue South, Birmingham, AL 35294 (e-mail: firstname.lastname@example.org).
Received October 1, 2018
Accepted March 2, 2019