Glaucoma is the leading cause of irreversible blindness in Black patients. Prior research shows that Black patients are significantly less likely to be educated about glaucoma by their eye care providers, and are significantly less likely than White patients to take 80% or more of their prescribed glaucoma medication(s) during the 60 days immediately following their doctor visits. To repair this inequity, scientists from several U.S. universities and medical institutions tested the effectiveness of an educational intervention to increase Black patient-provider engagement during visits regarding glaucoma and its treatment.*

What the researchers did

The research team conducted a prospective randomized, controlled trial to test the efficacy of a glaucoma question prompt list/video intervention. The study participants consisted of 189 Black patients with a glaucoma diagnosis who:

• Were currently taking one or more glaucoma medications, and 
• Self-reported being nonadherent to their medication regimen.

Each participant was assigned to one of two groups that would either:

• Receive standard care, or 
• Watch an educational video (about 11 minutes) emphasizing the importance of asking questions, and receive a glaucoma-based question prompt list (that was previously developed with patient input from focus groups), both to be completed just before clinic visits. 

What they found

The researchers found that participants in the intervention (video) group were significantly more likely than those in the standard care group to:

• Ask one or more questions about glaucoma (69% v. 28%) 
• Ask one or more questions about glaucoma medications (55% v. 32%)
• Receive more areas of education about glaucoma from their providers during visits 
• Receive more areas of education about glaucoma medications from providers

More specifically, patients in the invention group:

• Asked an average of 3.1 questions v. the standard care group’s 1.8 questions
• Received information about 4 areas of glaucoma v. 2.5 areas
• Received information about 4.1 glaucoma medication areas v. 3.1 medication areas

What it means

The study results demonstrate that improved patient question-asking prompts increased education from providers, which could help lead to:

• Improved adherence and self-management regarding glaucoma medications, and
• Improved intraocular pressure and vision outcomes. 

The researchers have continued to follow the trial participants to determine whether and how the increased education impacts patient adherence. They encourage providers to use these resources to improve patient-provider engagement and patient outcomes. They also encourage further research specifically geared toward other underserved communities.

The full patient question prompt list can be found in the study.

*Robin, A.L., Sleath, B., Carpenter, D.M., Davis, S.A., et al. (2023, March/April). Improving Black Patient Question-Asking and Provider Education During Glaucoma Visits. Ophthalmology Glaucoma 6(2): 206-214.  https://www.ophthalmologyglaucoma.org/article/S2589-4196(22)00188-0/fulltext 

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