Original articleDoctor–Patient Communication in Glaucoma Care: Analysis of Videotaped Encounters in Community-Based Office Practice
Section snippets
Patient and Physician Selection
The investigators consisted of 2 glaucoma specialists (DF, HQ), 2 specialists in patient–doctor communications (SH, MO), a research methodologist (SK), and a statistician (JM). The study received Independent Investigational Review Board Inc. (Plantation, FL), and Johns Hopkins Investigational Review Board approval. Written, informed consent was obtained from both physicians and patients. A total of 743 invitation letters was mailed to community-based ophthalmologists who see ≥5 glaucoma
Results
A total of 23 ophthalmologists and 50 patients were enrolled in the study from November through December 2007 (Table 3, Table 4). Ophthalmologists had an average of 22.7 years in practice, had a mean age of 53.2 years (range, 39–67), and were largely male (21/23, 91.3%; Table 3). Patients were 58% female, with an average age of 72 years; all patients had seen the study ophthalmologist previously and 62% had been seeing the study ophthalmologist for ≥5 years (Table 4). The average visit lasted
Discussion
This is the first ophthalmic study of videotaped doctor–patient interactions. By and large, the interactions were physician centered rather than patient centered and were ineffective in detecting patients who admitted to missing doses in the previous week, a surrogate for nonadherence. Physicians dominated the average 5.8 minutes of dialogue, speaking 70% of the words spoken and asking twice the number of questions compared with patients. Physicians almost exclusively employed closed-ended
References (37)
- et al.
Glaucoma management among individuals enrolled in a single comprehensive insurance plan
Ophthalmology
(2005) - et al.
Compliance with topical pilocarpine treatment
Am J Ophthalmol
(1986) - et al.
Compliance with topical timolol treatment
Am J Ophthalmol
(1987) - et al.
Adherence with topical glaucoma medication monitored electronically: the Travatan Dosing Aid Study
Ophthalmology
(2009) - et al.
Reliability of blood glucose monitoring by patients with diabetes mellitus
Am J Med
(1984) - et al.
Unpredictability of deception in compliance with physician-prescribed bronchodilator inhaler use in a clinical trial
Chest
(2000) - et al.
The impact of general practitioners' patient-centredness on patients' post-consultation satisfaction and enablement
Soc Sci Med
(2002) - et al.
Evidence-based guidelines for teaching patient-centered interviewing
Patient Educ Couns
(2000) - et al.
Audio-visual recording of patient-GP consultations for research purposes: a literature review on recruiting rates and strategies
Patient Educ Couns
(2008) Variations in patients' adherence to medical recommendations: a quantitative review of 50 years of research
Med Care
(2004)
Treatment for glaucoma: adherence by the elderly
Am J Public Health
Persistence and adherence with topical glaucoma therapy
Am J Ophthalmol
Noncompliance with ocular hypotensive treatment in patients with glaucoma or ocular hypertension: an evidence-based review
Ophthalmology
Doctor-patient communication, health-related beliefs, and adherence in glaucoma: results from the Glaucoma Adherence and Persistence Study
Ophthalmology
In-office discussions of migraine: results from the American Migraine Communication Study
J Gen Intern Med
Healthcare provider-patient communication and migraine assessment: results of the American Migraine Communication Study, phase II
Curr Med Res Opin
The discourse of medical encounters
On interactional sociolinguistic method
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Available online: September 10, 2009.
Manuscript no. 2008-1347.
Financial Disclosure(s): Funded with a grant from Pfizer Inc. The sponsor participated in the study design, data analysis and interpretation, and preparation and review of the manuscript.
The authors have made the following disclosures(s): Steven R. Hahn – Consultant, Pfizer GlaxcoSmithKline PLC, AstraZeneca International, Astellas Pharma Inc., Ortho-McNeil
David S. Friedman – Consultant, Pfizer and Alcon, Inc.; Paid consultant - NicOx S.A., and ORBIS International; Received equipment – Carl Zeiss Meditec, Inc., Takagi Seiko Co., Ltd., and Heidelberg Engineering, Inc.
Harry A. Quigley – Consultant, Pfizer
Meaghan Onofrey – Consultant, Pfizer
Corey Eagan – Consultant, Pfizer
Sameer Kotak – Employee, Pfizer
Elizabeth Kim – Employee, Pfizer
Jack Mardekian – Employee, Pfizer
Drs Friedman and Quigley's relationships with Pfizer are managed by the Johns Hopkins Committee on Conflict of Interest.