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. 2023 Nov;37(16):3446-3454.
doi: 10.1038/s41433-023-02532-w. Epub 2023 Apr 24.

Treatment expectations in glaucoma: what matters most to patients?

Atika Safitri  1   2 , Evgenia Konstantakopoulou  1   2   3 , Kuang Hu  4   5 , Gus Gazzard  1   2
Affiliations

Treatment expectations in glaucoma: what matters most to patients?

Atika Safitri et al. Eye (Lond). 2023 Nov.

Abstract

Background/objectives: Recent clinical trials in glaucoma have used patient-reported outcome measures (PROMs) of health-related quality of life to evaluate interventions. However, existing PROMs may not be sufficiently sensitive to capture changes in health status. This study aims to determine what really matters to patients by directly exploring their treatment expectations and preferences.

Subjects/methods: We conducted a qualitative study using one-to-one semi-structured interviews to elicit patients' preferences. Participants were recruited from two NHS clinics serving urban, suburban and rural populations in the UK. To be relevant across glaucoma patients under NHS care, participants were sampled to include a full range of demographic profiles, disease severities and treatment histories. Interview transcripts were evaluated using thematic analysis until no new themes emerged (saturation). Saturation was established when 25 participants with ocular hypertension, mild, moderate and advanced glaucoma had been interviewed.

Results: Themes identified were: Patients' experiences of living with glaucoma, patients' experiences of having glaucoma treatment, most important outcomes to patients, and COVID-related concerns. Participants specifically expressed their most important concerns, which were (i) disease-related outcomes (intraocular pressure control, maintaining vision, and being independent); and (ii) treatment-related outcomes (treatment that does not change, drop-freedom, and one-time treatment). Both disease-related and treatment-related experiences were covered prominently in interviews with patients across the spectrum of glaucoma severity.

Conclusions: Outcomes related both to the disease and its treatment are important to patients with different severities of glaucoma. To accurately evaluate quality of life in glaucoma, PROMs may need to assess both disease-related and treatment-related outcomes.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Purposive sampling covered a broad range of disease severities and treatment histories.
Numbers of participants with corresponding disease severity and treatment history are shown. Worse eye and better eye were defined for each participant using Mean Deviation from Humphrey 24-2 visual field tests. OHT ocular hypertension.
Fig. 2
Fig. 2. Topic guide.
Used for semi-structured interviews.
Fig. 3
Fig. 3. Percentage of total codes per theme categorized according to disease severity in worse eye or better eye or using integrated visual field.
A larger area indicates a greater proportion of items coded.
See this image and copyright information in PMC

Dataset described in

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