Patient-reported outcome and experience measures (POEM) of a community-based glaucoma clinic in Cambridge, UK: an observational study

英国剑桥一家社区青光眼诊所的患者报告结局和体验指标(POEM):一项观察性研究

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Abstract

OBJECTIVES: Glaucoma care demand in UK hospitals has exploded in recent years. This has resulted in a push to community (shared, virtual, etc) care models to reduce the burden on hospital systems and on patients. The study aimed to ascertain patient's experiences around various aspects of their care delivered in community clinics. DESIGN: Observational study. SETTING: Glaucoma Community Clinic, Cambridge, UK. PARTICIPANTS: Ninety-six consecutive patients (M:F 47:49, mean age 70±12 years), recruited from July to September 2022. OUTCOME MEASURES: Patients completed a modified glaucoma patient-reported outcome and experience measure (POEM) regarding their clinic experience and perspective on their diagnosis, treatment and fear of blindness. Patient's thoughts of feeling safe under the community clinical team were gathered. Patient demographics including age, gender, postcodes and education history were used to find their corresponding Lower-Layer Super Output Areas and socioeconomic status. RESULTS: Patients had positive perceptions of their clinic experience. Ninety-six per cent of patients reported that their experience of attending the community clinic was comfortable, and 93% (n=92) felt the experience was the same as expected from the hospital. Feeling safe under the clinician team produced a mean Visual Analogue Scale (VAS) score of 90 (SD 15) and feeling care was organised produced a mean VAS score of 87 (SD 17). Age, gender, disease characteristics and socioeconomic status had no influence on perceived experience. Patients aged <60 years had significantly lower understanding of their diagnosis compared with older groups (p=0.027, η(2)=0.076), as did suspect glaucoma patients when compared with primary open glaucoma patients (p=0.045, η(2)=0.085). CONCLUSIONS: A large majority of patients expressed a positive experience, felt safe under the care of their clinical team and their care was well organised. Relatively younger patients (<60 years) and those with no confirmed diagnosis would likely benefit from more consultation time and educational materials to improve their understanding of glaucoma.

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