Shaodan Zhang1, Yuanbo Liang, Yanyun Chen, David C Musch, Chun Zhang, Ningli Wang. 1. *Key Laboratory of Ophthalmology of Shenyang, Department of Ophthalmology, The 4th People's Hospital of Shenyang, Shenyang Eye Research Institute, Shenyang †Department of Ophthalmology, Peking University Third Hospital, Peking University Health Science Center, Beijing ‡The Affiliated Eye Hospital, College of Ophthalmology and Optometry, Wenzhou Medical University, Zhejiang §Beijing TongRen Eye Center, Beijing TongRen Hospital, Capital Medical University, Beijing, Fengtai, China Departments of ∥Ophthalmology and Visual Sciences ¶Epidemiology, University of Michigan, Ann Arbor, MI.
Abstract
PURPOSE: To evaluate patient-perceived quality of life with glaucoma and to assess whether ophthalmologists fully appreciate patients' perceptions through utility analysis. PATIENTS AND METHODS: Utility values were obtained from 87 glaucoma patients by linear rating scale (RS), standard gamble for blindness (SG), and time trade-off (TTO) methods. Identical questionnaires were delivered to ophthalmologists (n=26) at the same center, who were asked to assume they had mild (MD in better-seeing eye ≥-6 dB) or moderate to severe (MD in better-seeing eye <-6 dB) glaucoma. Responses from patients and ophthalmologists were compared. RESULTS: Patients with mild glaucoma gave a utility value of 0.70±0.14, 0.85±0.14, and 0.77±0.14 with RS, SG, and TTO method, respectively. Those with moderate to severe glaucoma generated corresponding utilities of 0.56±0.20, 0.75±0.20, and 0.78±0.11. RS and SG utilities were affected by disease severity and history of glaucoma surgery, whereas TTO utility was mainly related with education level and employment status of the patients. Ophthalmologists reported higher utility values than their patients when mild glaucoma was assumed (0.81±0.14, 0.96±0.05, and 0.95±0.05 for RS, SG, and TTO methods, respectively; P<0.05). Given the scenario of moderate to severe glaucoma, ophthalmologists gave significantly lower RS (0.35±0.21, P<0.001), but similar SG (0.74±0.27, P=0.84) and TTO (0.82±0.13, P=0.40) utility values, than the patients. CONCLUSIONS: Utility values are considerably decreased in Chinese patients with glaucoma. Ophthalmologists tend to substantially underestimate the impact of mild glaucoma on patients' quality of life. Better understanding patients' perceptions of glaucoma would be helpful for the establishment of shared decision making and patient-centered care.
PURPOSE: To evaluate patient-perceived quality of life with glaucoma and to assess whether ophthalmologists fully appreciate patients' perceptions through utility analysis. PATIENTS AND METHODS: Utility values were obtained from 87 glaucomapatients by linear rating scale (RS), standard gamble for blindness (SG), and time trade-off (TTO) methods. Identical questionnaires were delivered to ophthalmologists (n=26) at the same center, who were asked to assume they had mild (MD in better-seeing eye ≥-6 dB) or moderate to severe (MD in better-seeing eye <-6 dB) glaucoma. Responses from patients and ophthalmologists were compared. RESULTS:Patients with mild glaucoma gave a utility value of 0.70±0.14, 0.85±0.14, and 0.77±0.14 with RS, SG, and TTO method, respectively. Those with moderate to severe glaucoma generated corresponding utilities of 0.56±0.20, 0.75±0.20, and 0.78±0.11. RS and SG utilities were affected by disease severity and history of glaucoma surgery, whereas TTO utility was mainly related with education level and employment status of the patients. Ophthalmologists reported higher utility values than their patients when mild glaucoma was assumed (0.81±0.14, 0.96±0.05, and 0.95±0.05 for RS, SG, and TTO methods, respectively; P<0.05). Given the scenario of moderate to severe glaucoma, ophthalmologists gave significantly lower RS (0.35±0.21, P<0.001), but similar SG (0.74±0.27, P=0.84) and TTO (0.82±0.13, P=0.40) utility values, than the patients. CONCLUSIONS: Utility values are considerably decreased in Chinese patients with glaucoma. Ophthalmologists tend to substantially underestimate the impact of mild glaucoma on patients' quality of life. Better understanding patients' perceptions of glaucoma would be helpful for the establishment of shared decision making and patient-centered care.
Authors: Ivan Sencanic; Tatjana Gazibara; Jelena Dotlic; Miroslav Stamenkovic; Vesna Jaksic; Marija Bozic; Anita Grgurevic Journal: Int J Ophthalmol Date: 2018-10-18 Impact factor: 1.779