title: The association between compliance with recommended follow-up and glaucomatous disease severity in a county hospital population.
abstract: OBJECTIVE
  To assess the association between insufficient follow-up and clinical parameters such as disease severity and medication use among glaucoma patients at a metropolitan county hospital.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Two-hundred and six patients with established glaucoma were recruited from San Francisco General Hospital. Subjects were classified based on compliance with recommended follow-up examination intervals over the year preceding commencement of the study, as determined by patient medical records. Glaucoma severity was determined based on the American Academy of Ophthalmology Preferred Practice Patterns guidelines. Multivariate logistic regression analysis was used to assess the relationship between adherence with follow-up visits and disease severity.
  
  
  RESULTS
  After adjustment for the impact of potential confounding variables, subjects with severe glaucomatous disease were found to have been less adherent to their recommended follow-up than those patients with mild or moderate glaucomatous disease (adjusted OR 1.89, 95% CI 1.21-2.94; P = .01). Subjects who were on glaucoma medications were found to be less adherent to follow-up recommendations (adjusted OR 3.29, 95% CI 1.41-7.65, P = .01).
  
  
  CONCLUSIONS
  Subjects with poor follow-up adherence were significantly more likely to have severe glaucomatous disease, suggesting that poor follow-up may contribute to disease worsening or, alternatively, those with more severe disease are less inclined to follow up at appropriate intervals.
authors.affiliation: Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Cindy
authors.initials: C
authors.lastname: Ung
authors.forename: Yohko
authors.initials: Y
authors.lastname: Murakami
authors.forename: Elisa
authors.initials: E
authors.lastname: Zhang
authors.forename: Tatyana
authors.initials: T
authors.lastname: Alfaro
authors.forename: Monica
authors.initials: M
authors.lastname: Zhang
authors.forename: Michael I
authors.initials: MI
authors.lastname: Seider
authors.forename: Kuldev
authors.initials: K
authors.lastname: Singh
authors.forename: Shan C
authors.initials: SC
authors.lastname: Lin
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use; D003266:Continuity of Patient Care / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology*; D019983:Guideline Adherence; D006766:Hospitals, County / Q000706:statistics & numerical data*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects / Q000502:physiology; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009819:Office Visits; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
chemical_list: D000959:Antihypertensive Agents