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. 2023 Oct 3;12(10):11.
doi: 10.1167/tvst.12.10.11.

Barriers and Facilitators to Ophthalmology Visit Adherence in an Urban Hospital Setting

Angelica C Scanzera  1 , R McKinley Sherrod  2 , Archit V Potharazu  2   3 , Diana Nguyen  4 , Cameron Beversluis  2 , Niranjan S Karnik  5 , Robison V P Chan  1 , Sage J Kim  6 , Jerry A Krishnan  2 , Hugh Musick  2
Affiliations

Barriers and Facilitators to Ophthalmology Visit Adherence in an Urban Hospital Setting

Angelica C Scanzera et al. Transl Vis Sci Technol. .

Abstract

Purpose: To explore barriers and facilitators to completing scheduled outpatient appointments at an urban academic hospital-based ophthalmology department.

Methods: Potential participants were stratified by neighborhood Social Vulnerability Index (SVI) (range, 0-1.0, higher scores indicate greater vulnerability), and semistructured interviews were conducted with individuals 18 years and older with an SVI of greater than 0.61 (n = 17) and providers delivering care in the General Eye Clinic of the University of Illinois Chicago (n = 8). Qualitative analysis informed by human-centered design methods was conducted to classify barriers and facilitators into three domains of the Consolidated Framework for Implementation Research: outer setting, inner setting, and characteristics of individuals.

Results: There were four main themes-transportation, time burden, social support, and economic situation-all of which were within the outer setting of the Consolidated Framework for Implementation Research; transportation was most salient. Although providers perceived health literacy as a barrier affecting motivation, patients expressed a high motivation to attend visits and felt well-educated about their condition.

Conclusions: A lack of resources outside of the health system presents significant barriers for patients from neighborhoods with high SVI. Future efforts to improve adherence should focus on resource-related interventions in the outer setting. Improving access to eye care will require community-level interventions, particularly transportation.

Translational relevance: Understanding the barriers and facilitators within the Consolidated Framework for Implementation Research provides useful guidance for future interventions, specifically to focus future efforts to improve adherence on resource-related interventions.

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Conflict of interest statement

Disclosure: A.C. Scanzera, None; R.M. Sherrod, None; A.V. Potharazu, None; D. Nguyen, None; C. Beversluis, None; N.S. Karnik, research funding – National Institute on Drug Abuse and National Center for Advancing Translational Sciences; R.V.P. Chan, Owner/Equity – Alcon, Genentech, Ocular Therapeutix, Siloam Vision; Research funding – National Institutes of Health and Research to Prevent Blindness; S.J. Kim, None; J.A. Krishnan, research funding – National Institutes of Health, the Patient Centered Outcomes Research Institute, the American Lung Association, Regeneron, and consulting fees – GlaxoSmithKline, AstraZeneca, Bdata, Inc., and CereVu; H. Musick, None

Figures

Figure.
Figure.
Four primary themes organized within the outer setting, inner setting, and characteristics of individual domains of the CFIR. Multifactorial nature of barriers and facilitators is illustrated by the overlap between the four primary themes. COVID-19, coronavirus disease 2019.
See this image and copyright information in PMC

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