title: Trust in the provider and glaucoma-related blindness.
abstract: Purpose. We hypothesized that lower trust in the physician is associated with worse visual outcomes in glaucoma. Methods. Subjects completed the Trust in Provider Scale (TPS) and performed visual field tests at least two years apart. The primary outcome was glaucoma-related blindness. Results. Subjects with glaucoma-related blindness scored lower on the TPS (74.9 ± 7.4, n = 21) than subjects without blindness (78.8 ± 6.9, n = 39; P = 0.04). In white subjects, TPS scores were similar for blind (77.1 ± 7.7, n = 12) versus not blind subjects (76.4 ± 6.7, n = 10; P = 0.82). For nonwhite subjects, TPS scores were lower for blind (72.0 + 6.2, n = 9) versus not blind subjects (79.6 ± 6.9, n = 29; P = 0.005). In multiple regression models, the interaction between race and trust was significant (P = 0.007), indicating that the increase in odds for blindness with each unit decrease in TPS score was different for white versus nonwhite subjects. Discussion. Glaucoma patients' trust in the physician is associated with glaucoma-related blindness in this study. The association between lower trust in the physician with blindness in patients of nonwhite race deserves further attention as we strive to reduce disparities in visual outcomes.
authors.affiliation: Department of Ophthalmology, Duke Univeristy Medical Center, 2351 Erwin Road, P.O. Box 3802, Durham, NC 27710, USA ; Durham VA Medical Center, 508 Fulton Street, Durham, NC 27705, USA.
authors.forename: Kelly W
authors.initials: KW
authors.lastname: Muir
authors.affiliation: Department of Ophthalmology, Duke Univeristy Medical Center, 2351 Erwin Road, P.O. Box 3802, Durham, NC 27710, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Alder
authors.affiliation: Department of Ophthalmology, Univeristy of California at Los Angeles, Los Angeles, CA 90095, USA.
authors.forename: Anitra
authors.initials: A
authors.lastname: Thomas
authors.affiliation: Department of Ophthalmology, Duke Univeristy Medical Center, 2351 Erwin Road, P.O. Box 3802, Durham, NC 27710, USA.
authors.forename: Sara S
authors.initials: SS
authors.lastname: Crowell
authors.affiliation: Department of Ophthalmology, Duke Univeristy Medical Center, 2351 Erwin Road, P.O. Box 3802, Durham, NC 27710, USA.
authors.forename: Sandra S
authors.initials: SS
authors.lastname: Stinnett
authors.affiliation: Department of Ophthalmology, Duke Univeristy Medical Center, 2351 Erwin Road, P.O. Box 3802, Durham, NC 27710, USA ; Department of Ophthalmology and Visual Sciences, University of Michigan, 1000 Wall Street, Ann Arbor, MI 48105, USA.
authors.forename: Paul P
authors.initials: PP
authors.lastname: Lee