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African American glaucoma patients who report medication non-adherence* and are exposed before clinic visits to the importance of question-asking during appointments are significantly more likely to inquire about their condition than those who do not receive pre-visit prompts. In a study published in the September/October 2022 Ophthalmology Glaucoma (Vol. 5/Issue 5), UNC Department of Ophthalmology Chair and Kittner Family Distinguished Professor Donald Budenz, MD, MPH, joined clinical research ophthalmologists from Duke University Department of Ophthalmology and several private practices across the U.S., as well as investigators from UNC Eshelman School of Pharmacy, in publishing a study entitled, “Improving black patient question-asking and provider education during glaucoma visits.” 

Funded by the Agency for Healthcare Research and Quality, this randomized, prospective trial tracked a cohort of 189 African American glaucoma trial enrollees assigned to either a usual care or an intervention group.  Those assigned to the intervention group watched an educational video emphasizing the importance of asking questions during visits with one’s glaucoma specialist. They also received a glaucoma question prompt list to complete before clinic visits. Visits were audiotaped, and patients were interviewed after their appointment.  

Study authors focused on two main outcome measures in observing both groups: 1) Whether study enrollees asked one or more questions during their recorded visits about glaucoma and glaucoma medications; and 2) The number of glaucoma and glaucoma medication areas the provider educated the patient about during the visit. Additional primary outcome measures included measuring intraocular pressure and surveying enrollees on self-reported glaucoma medication adherence.  

Over a 12-month study, Dr. Budenz and colleagues found that African American patients in the trial’s intervention group were significantly more likely than those in the usual care group to ask at least one question about glaucoma.  Similarly, intervention group participants were significantly more likely to receive a wider range of education about glaucoma during clinic visits. The study concluded that providing a pre-visit glaucoma educational video and a question prompt list to black glaucoma patients who report medication non-adherence increases question-asking and provider education about glaucoma and glaucoma medications in this population.  

Dr. Budenz stated: “Glaucoma is the leading cause of blindness in African Americans. Our prior studies found that African Americans are significantly less likely to be educated about glaucoma by their ophthalmologists and significantly less likely to be adherent to their glaucoma medications than Caucasians. By providing patients with a question prompt list, we were able to significantly increase question asking of African American patients to their ophthalmologist, which improves education and, hopefully, compliance with therapy.”  

To read an online synopsis of this study, go to the September/October 2022 issue of Ophthalmology Glaucoma. 

* Study eligibility: African-American patients with a glaucoma diagnosis who were currently taking one or more glaucoma medications and reported being non-adherent.


To read coverage of this multi-disciplinary study in the University of North Carolina publication The Well, click here.