Loss to Follow up among Glaucoma Patients at a Tertiary Eye Center over 10 Years: Incidence, Risk Factors, and Clinical Outcomes

ABSTRACT

Purpose

To assess the incidence, risk factors, and clinical consequences of loss to follow up (LTFU) among glaucoma patients at our institution over a 10-year period.

Methods

This retrospective study examined LTFU among a cohort of glaucoma patients with a clinical encounter in 2010. LTFU was defined as 52 weeks or more without an encounter and without alternative reason for discontinued care, such as discharge, documented move, or death. Baseline demographic and clinical characteristics were collected and compared between LTFU and non-LTFU groups using a logistic regression model to identify risk factors for LTFU. Odds ratios (ORs) are reported with 95% confidence intervals. Clinical outcomes were documented for LTFU patients who returned after a lapse in care.

Results

Among the 395 included patients, 132 (33%) were LTFU over the 10-year study period. Characteristics associated with LTFU in a logistic regression model included greater disease severity (OR = 1.03 [1.01–1.05], p = .023, for each worsening decibel of mean deviation) and in-state rather than out-of-state residence (OR = 2.76 [1.12–6.80], p = .027). Other potential risk factors that did not reach significance included male gender (OR = 1.39 [0.92–2.13], p = .124), Black race (OR = 1.40 [0.91–2.16] p = .123), and legal blindness (OR = 1.58 [0.91–2.76] p = .107). Among the 132 patients who were LTFU, only 23 (17%) later returned to care, two-thirds (15/23) of whom returned with disease progression or complication.

Conclusion

One-third of glaucoma patients became LTFU over a 10-year period, and LTFU may be associated with poor clinical outcomes. More research is needed to understand reasons for LTFU and to promote regular glaucoma care.

KEYWORDS:

• loss to follow up
• glaucoma
• appointment nonattendance
• no-show

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by funding from the Henry L. Hillman Foundation, NIH CORE Grant P30 EY08098, the Eye and Ear Foundation of Pittsburgh, and an unrestricted grant from Research to Prevent Blindness to the Department of Ophthalmology at the University of Pittsburgh. Dr. Williams receives funding from Research to Prevent Blindness and a Mentoring for the Advancement of Physician Scientists (MAPS) award from the American Glaucoma Society.