A Randomized, Controlled Trial to Test the Effectiveness of a Glaucoma Patient Navigator to Improve Appointment Adherence
- 1. Pokhara University School of Health and Allied Sciences A Randomized, Controlled Trial to Test the Effectiveness of a Glaucoma Patient Navigator to Improve Appointment Adherence Presented By : Deepa kumari karn Seminar 3nd , M Pharm (C.P), 1st Sem
- 2. Pokhara University School of Health and Allied Sciences Table of Content • Introduction • Research Question • Literature Review • Objective – General Objective – Specific Objective • Rational of Study
- 3. Pokhara University School of Health and Allied Sciences • Methods – Study design – Sample size • Results
- 4. Pokhara University School of Health and Allied Sciences • Methods – Study design – Participants – Sample size • Results – Efficacy assessment – Statistical Analysis • Discussion • Conclusion • References 5/29/2017 4
- 5. Pokhara University School of Health and Allied Sciences Introduction • Glaucoma is a progressive neurodegenerative disorder that affects the optic nerve and the inner layers of the retina • Appropriate treatment and follow-up eye care are crucial in preventing vision loss due to glaucoma • Various research suggested that there are various factors that is associated with the poor follow up adherence among those people diagnosed with glaucoma who were prescribed intraocular pressure- lowering eye drops
- 6. Pokhara University School of Health and Allied Sciences • A patient navigator is a member of a health-care team who helps patients “navigate” the health-care system and get timely care • To determine the impact of a patient navigator on glaucoma eye care follow-up adherence, the researcher initiated a 1-year prospective, randomized, controlled trial in an urban community setting versus office-based setting
- 7. Pokhara University School of Health and Allied Sciences Research Question • What is the impact of a patient navigator on glaucoma eye care follow-up adherence, in 1-year prospective, randomized, controlled trial?
- 8. Pokhara University School of Health and Allied Sciences Literature Review • The patient navigator concept was first introduced in the 1990s by Dr Harold Freeman to help females obtain breast cancer screening • Patient navigation programs have been shown in several randomized, controlled trials to improve appointment adherence, initiation of treatment, and patient’s quality of life
- 9. Pokhara University School of Health and Allied Sciences • Patient navigators have been utilized in a variety of medical fields with the navigators serving to help patients schedule doctor’s appointments, determine insurance requirements, arrange transportation, make appointment reminder calls, and accompany patients to their appointments • There was limited data on the use of a patient navigator in an ophthalmic patient population and its efficacy in improving follow-up adherence and preventing vision loss, particularly among patients diagnosed with glaucomatous diseases
- 10. Pokhara University School of Health and Allied Sciences Figure: Role of the Patient Navigator
- 11. Pokhara University School of Health and Allied Sciences Objective • General Objective – To determine the impact of a patient navigator on glaucoma eye care follow-up adherence in an urban community setting versus office-based setting • Specific Objective – Assessment of the patient for the eligibility for the inclusion for the research – To evaluate how community- and office-based interventions affected disease progression by assessing changes in clinical diagnoses
- 12. Pokhara University School of Health and Allied Sciences – Collection of the patient’s demographic and clinical characteristics – Assessment of medication adherence, and a complete eye examination
- 13. Pokhara University School of Health and Allied Sciences Rational of Study • There was limited data on the use of a patient navigator in an ophthalmic patient population and its efficacy in improving follow-up adherence and preventing vision loss, particularly among patients diagnosed with glaucomatous diseases
- 14. Pokhara University School of Health and Allied Sciences Methods • Study Design:- – This study was a randomized, controlled trial where subjects were equally randomized into one of three groups for a 1-year period – Approved by the Institutional Review Board of Wills Eye Hospital and conducted in accordance to the Declaration of Helsinki – Subjects were equally randomized into one of three groups for a 1-year period
- 15. Pokhara University School of Health and Allied Sciences • Group 1 (G1) received follow-up eye care in a community-based setting with assistance from a patient navigator • Group 2 (G2) received follow-up eye care in an office- based setting with assistance from a patient navigator • Group 3 (G3) received follow-up eye care in an office- based setting without a patient navigator
- 16. Pokhara University School of Health and Allied Sciences • Sample size
- 17. Pokhara University School of Health and Allied Sciences Results • Effectiveness Assessment Table : Recommended follow-up visits by diagnosis and treatment
- 18. Pokhara University School of Health and Allied Sciences Table : Patient’s demographic and clinical characteristics (n=155 patients)
- 19. Pokhara University School of Health and Allied Sciences • Statistical Analysis Table : Factors associated with appointment adherence
- 20. Pokhara University School of Health and Allied Sciences • The appointment adherence rates were compared among the three groups using chi-square test at a significance level of 0.05
- 21. Pokhara University School of Health and Allied Sciences
- 22. Pokhara University School of Health and Allied Sciences
- 23. Pokhara University School of Health and Allied Sciences
- 24. Pokhara University School of Health and Allied Sciences
- 25. Pokhara University School of Health and Allied Sciences
- 26. Pokhara University School of Health and Allied Sciences References • Hark AL, Johnson MD, Berardi G, Patel S N, Zeng L, Dai Y, Mayro LE, Waisbourd M and Katz JL (2016) A Randomized, Controlled Trial to Test the Effectiveness of a Glaucoma Patient Navigator to Improve Appointment Adherence, Dovepress Journal 10, 1739–1748. • Freeman HP (2012) The origin, evolution, and principles of patient navigation, Cancer Epidemiol Biomarkers Prev 21(10),1614–1617.