Provider use of collaborative goal setting with glaucoma patients.
OBJECTIVE
The purpose of this preliminary study was to describe the extent to which providers used collaborative goal setting and individualized assessment with patients who were newly prescribed glaucoma medications.


METHODS
English-speaking glaucoma suspect patients from six ophthalmology clinics who were newly prescribed glaucoma medications had their medical visits videotaped and were interviewed after the visits. The videotapes were transcribed and coded to examine provider use of collaborative goal setting and individualized assessment.


RESULTS
Fifty-one patients seeing 12 ophthalmologists participated. Providers gave patients glaucoma treatment options during 37% of the visits; only five providers gave patients treatment options Providers asked for patient treatment preferences in less than 20% of the visits; only two providers asked for patient treatment preferences. Providers were significantly more likely to ask African American patients for their preferences or ideas concerning treatment than non-African American patients (Pearson χ² = 4.1, p = 0.04). Providers were also significantly more likely to ask African American patients about their confidence in using glaucoma medication regularly than non-African American patients (Pearson χ² = 8.2, p = 0.004). Providers asked about patient views about glaucoma in less than 20% of the visits; five providers asked patients their views on glaucoma and its treatment. Providers were significantly more likely to ask African American patients about their views on glaucoma than non-African American patients (Pearson χ² = 5.62, p = 0.02).


CONCLUSIONS
Eye care providers often did not use collaborative goal setting or conduct individualized assessments of patient views on glaucoma when prescribing treatment for the first time.
*PhD †PhD candidate ‡PharmD §PhD, MSPH ∥MD University of North Carolina Eshelman School of Pharmacy (BS, CS, SJB, RS, DMC), Cecil G. Sheps Center for Health Services Research (BS), University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Ophthalmology, School of Medicine, Duke University, Durham, North Carolina (KWM); Durham VA Medical Center, Health Services Research and Development, Durham, North Carolina (KWM); Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah (MEH); and Department of International Health, Bloomberg School of Public Health, and Department of Ophthalmology, School of Medicine, Johns Hopkins University, Baltimore, Maryland (ALR).
Betsy
B
Sleath
Catherine
C
Slota
Susan J
SJ
Blalock
Robyn
R
Sayner
Delesha M
DM
Carpenter
Kelly W
KW
Muir
Mary Elizabeth
ME
Hartnett
Alan L
AL
Robin
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D005006:Ethnicity; D005260:Female; D005901:Glaucoma / Q000188:drug therapy / Q000523:psychology*; D006282:Health Personnel / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000188:drug therapy / Q000523:psychology; D009885:Ophthalmology / Q000706:statistics & numerical data*; D010347:Patient Care Planning / Q000706:statistics & numerical data*; D010358:Patient Participation; D010361:Patients / Q000523:psychology*; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014741:Video Recording
D000959:Antihypertensive Agents