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Glaucoma Patient Knowledge, Perceptions, and Predispositions for Telemedicine

Rhodes, Lindsay A., MD*; Huisingh, Carrie E., PhD*; McGwin, Gerald, PhD*,†; Girkin, Christopher A., MD, MSPH*; Owsley, Cynthia, PhD, MSPH*

doi: 10.1097/IJG.0000000000001238
Original Studies

Purpose: The purpose was to identify factors associated with older glaucoma patients’ knowledge of, perceptions of, and predispositions for telemedicine use.

Materials and Methods: 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.

Results: 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.

Conclusions: 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:

Received October 1, 2018

Accepted March 2, 2019

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