Abstract Details

Title Factors Associated with Adherence to Follow-up Recommendations in Neuro-Ophthalmology

Topic Neuro-ophthalmology/Neuro-otology

Presentation(s) Neuro-ophthalmology/Neuro-otology Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 004

Background Poor compliance with medical recommendations contributes to worsened medical outcomes and increased healthcare costs. Research suggests that improving adherence to therapy may have greater impact on health outcomes than any single improvement in treatment regimens. Understanding factors associated with and contributing to poor medical adherence is important for identifying patients who need extra support and designing interventions to improve compliance.

Objective The objective of this study was to identify factors associated with poor adherence to neuro-ophthalmology physician recommendations.

Design/Methods Consecutive adult patients with scheduled neuro-ophthalmology appointments at a tertiary care academic medical center completed personality and illness-perception assessments using validated surveys. Compliance with physician recommendations was assessed via chart review one year following survey administration. Associations between follow-up appointment completion and demographics, distance travelled, number of medications (as a proxy for health), health insurance, appointment type, and personality and illness-perception dimensions were assessed.

Results Among 80 respondents (95% response rate (80/84), ages 19-91 years, 65% female, 66.3% White-Non-Hispanic, 13.8% Asian, 11.3% White-Hispanic), physician recommendations included prescription medications (n=19, 100% compliance), referral to other medical specialists (n=14, 42.9% compliance), follow-up (n=60, 55% compliance), lab tests (n=3, 66.7% compliance), ophthalmic tests (n=36, 63.9% compliance), and radiology studies (n=12, 91.7% compliance). Lack of follow-up completion was more prevalent in White-non-Hispanic race/ethnicity (53.8% vs. 25.0%, p=0.035, chi-square), and those with scheduled follow-up of ≥6 months (72.2% vs. 33.3%, p=0.006, chi-square), but not other parameters studied.

Conclusions Poor follow-up compliance was associated with White-non-Hispanic race/ethnicity and follow-up time of ≥6 months, but not personality or illness-perception factors. This highlights a combination of intrinsic and extrinsic factors influencing compliance, and suggests improvement by targeting subjects with longer follow-up intervals for intervention. A larger sample size is required to examine patient adherence to other physician recommendations and to adequately identify areas in need of intervention.

Authors/Disclosures
Rem Aziz PRESENTER	Miss Aziz has nothing to disclose.
Heather Moss, MD, PhD, FAAN (Spencer Center for Vision Research at Stanford)	Dr. Moss has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Twenty Twenty Therapeutics. Dr. Moss has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Verana Health. Dr. Moss has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Medlink Inc. Dr. Moss has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Legal Firms. The institution of Dr. Moss has received research support from NIH. The institution of Dr. Moss has received research support from Department of Defense. The institution of Dr. Moss has received research support from Research to Prevent Blindness. Dr. Moss has received intellectual property interests from a discovery or technology relating to health care. Dr. Moss has received personal compensation in the range of $0-$499 for serving as a grant review panel with NASA. Dr. Moss has received personal compensation in the range of $0-$499 for serving as a grant review panel with National Institutes of Health. Dr. Moss has a non-compensated relationship as a Board of Directors with North American Neuro-ophthalmology Society that is relevant to AAN interests or activities.