J Minjy Kang1, Ayan Chatterjee2, Jullia A Rosdahl3, Hayden B Bosworth4, Sandra Woolson5, Maren Olsen4, Malina Sexton3, Miriam Kirshner5, Kelly W Muir6. 1. Department of Ophthalmology, Northwestern University, Chicago, Illinois. 2. Glaucoma Service, Wills Eye Hospital, Philadelphia, Pennsylvania. 3. Department of Ophthalmology, Duke University, Durham, North Carolina. 4. Department of Ophthalmology, Duke University, Durham, North Carolina; Durham VA Medical Center, Durham, North Carolina. 5. Durham VA Medical Center, Durham, North Carolina. 6. Department of Ophthalmology, Duke University, Durham, North Carolina; Durham VA Medical Center, Durham, North Carolina. Electronic address: jmkang@northwestern.edu.
Abstract
PURPOSE: To assess the relationship between health literacy and successful glaucoma drop administration. DESIGN: Substudy of a single-site interventional randomized controlled trial. PARTICIPANTS: Veterans receiving care at the Durham Veterans Affairs Eye Clinic who had a diagnosis of open-angle glaucoma were recruited if they endorsed poor drop adherence. METHODS: Participants underwent a health literacy evaluation using the Rapid Estimate of Adult Literacy in Medicine (REALM) as well as a qualitative assessment of eye drop administration technique using 3 different criteria: (1) the drop was instilled in the eye, (2) only 1 drop was dispensed, and (3) the bottle was not potentially contaminated. A multivariate logistic regression model was used to assess the association of REALM score and successful drop administration, adjusting for age, disease severity, and Veterans Administration Care Assessment Needs (CAN) score. MAIN OUTCOME MEASURES: Successful drop administration. RESULTS: Of the 179 participants with REALM scores and observed drop administration, 78% read at a high school level (HSL) or more and 22% read at less than HSL. Of the 179 participants, 87% (n = 156) successfully instilled the drop into the eye (criterion 1). A greater proportion of participants who read at HSL or more successfully instilled the drop in the eye compared with those reading at less than HSL (90.6% vs. 75.0%; P = 0.02). Rates of success with criterion 1 were similar across different levels of visual field severity. Care Assessment Needs scores were not statistically significant between those who did and those did not have successful overall drop technique. CONCLUSIONS: Poor health literacy may be associated with decreased successful drop instillation in the eye in patients with glaucoma. Screening for and considering health literacy in developing interventions to improve glaucoma self-management may improve treatment adherence in a vulnerable population. Published by Elsevier Inc.
PURPOSE: To assess the relationship between health literacy and successful glaucoma drop administration. DESIGN: Substudy of a single-site interventional randomized controlled trial. PARTICIPANTS: Veterans receiving care at the Durham Veterans Affairs Eye Clinic who had a diagnosis of open-angle glaucoma were recruited if they endorsed poor drop adherence. METHODS: Participants underwent a health literacy evaluation using the Rapid Estimate of Adult Literacy in Medicine (REALM) as well as a qualitative assessment of eye drop administration technique using 3 different criteria: (1) the drop was instilled in the eye, (2) only 1 drop was dispensed, and (3) the bottle was not potentially contaminated. A multivariate logistic regression model was used to assess the association of REALM score and successful drop administration, adjusting for age, disease severity, and Veterans Administration Care Assessment Needs (CAN) score. MAIN OUTCOME MEASURES: Successful drop administration. RESULTS: Of the 179 participants with REALM scores and observed drop administration, 78% read at a high school level (HSL) or more and 22% read at less than HSL. Of the 179 participants, 87% (n = 156) successfully instilled the drop into the eye (criterion 1). A greater proportion of participants who read at HSL or more successfully instilled the drop in the eye compared with those reading at less than HSL (90.6% vs. 75.0%; P = 0.02). Rates of success with criterion 1 were similar across different levels of visual field severity. Care Assessment Needs scores were not statistically significant between those who did and those did not have successful overall drop technique. CONCLUSIONS: Poor health literacy may be associated with decreased successful drop instillation in the eye in patients with glaucoma. Screening for and considering health literacy in developing interventions to improve glaucoma self-management may improve treatment adherence in a vulnerable population. Published by Elsevier Inc.
Entities:
Keywords:
Drop administration; Glaucoma medical treatment; Health literacy; Patient adherence