Patient education preferences in ophthalmic care

Figures & data

Figure 1 Racial distribution of the eye center population and the survey respondents.

Notes: During the month of survey distribution (May 2012), 7,715 patients were seen at the eye center. The upper graph represents the racial distribution of the total eye center population seen during May 2012. Most were White (73%) or Black (24%). The lower graph represents the racial distribution of the survey respondents who indicated a race on their survey. Of the 611 surveys completed for the quality improvement project, 450 respondents wrote in their race, with 71% White and 25% Black. The racial distribution is very similar between the two groups; P<0.0001 using the chi‐squared test.

Figure 2 Preferred learning practices.

Notes: The survey question asked “Which of the following would help you to learn about eye health and disease? Check all that apply.” The bars represent the percentage of respondents who selected each answer. Overall, one‐on‐one sessions with providers were preferred. One‐on‐one sessions with eye health educators and resources recommended by the provider (both printed and websites) were preferred. There was interest in all practices listed.

Table 1 Preferred learning practice with age and race

	Age mean, years (SD)	Race Number of survey respondents (%, within race category)					P-value*
		White	Black	Hispanic	Asian	Other
One-on-one session with eye care provider	56 (19)	209 (68%)	82 (73%)	6 (60%)	6 (50%)	33 (20%)	<0.001
Group session with eye care provider	57 (14)	43 (14%)	22 (20%)	0	1 (8%)	8 (5%)	0.001
One-on-one session with eye health educator	58 (18)	107 (35%)	46 (41%)	2 (20%)	4 (33%)	21 (13%)	<0.001
Group session with eye health educator	58 (15)	39 (13%)	16 (14%)	0	2 (17%)	4 (2%)	<0.001
Lectures	58 (17)	43 (14%)	21 (19%)	1 (10%)	1 (8%)	6 (4%)	<0.001
Printed materials chosen by provider	57 (18)	145 (47%)	56 (50%)	1 (10%)	3 (25%)	18 (11%)	<0.001
Printed materials, patient’s choice	54 (19)	40 (13%)	15 (13%)	3 (30%)	2 (17%)	8 (5%)	0.006
Websites, patient’s choice	52 (18)	46 (15%)	12 (11%)	2 (20%)	1 (8%)	7 (4%)	0.003
Web-based learning modules	48 (18)	43 (14%)	15 (13%)	2 (20%)	3 (25%)	9 (5%)	0.011

Notes: The age and racial composition of the survey respondents who noted what learning practices would help to learn about eye diseases are summarized. The survey question was “Which of the following would help you to learn about eye health and disease? Check all that apply.” The age listed is the average age of the respondents who selected the learning practice. The racial distribution is shown, with the percentage within each racial category

* P‐value based on Fisher’s exact test of differences among proportions of race.

Abbreviation: SD, standard deviation.

Table 2 Ophthalmic topics and preferred learning practice

Ophthalmic topic	Preferred learning practice (P-value*) Comparison of those with and without interest in the ophthalmic topic
Cataracts	Group session with eye care provider (<0.001) One-on-one session with eye health educator (<0.001) Group session with eye health educator (<0.001) Lectures (in-person) (<0.001) Videos of lectures (0.007) Printed materials chosen by provider (0.016)
Macular degeneration	Group session with eye care provider (<0.001) Group session with eye health educator (<0.001) Lectures (in-person) (<0.001) Videos of lectures (0.001)
Glaucoma	One-on-one session with eye care provider (<0.001) Group session with eye care provider (<0.001) One-on-one session with eye health educator (<0.001) Group session with eye health educator (0.001) Lectures (in-person) (<0.001) Videos of lectures (<0.001) Printed materials chosen by provider (<0.001) Printed materials, patient’s choice (0.043) Websites, recommended by provider (<0.001)
Diabetic retinopathy	Group session with eye care provider (0.010) One-on-one session with eye health educator (0.009) Group session with eye health educator (0.031) Lectures (in-person) (0.029)
Dry eye	Group session with eye care provider (0.021) One-on-one session with eye health educator (<0.001) Group session with eye health educator (<0.001) Lectures (in-person) (<0.001) Videos of lectures (0.041) Printed materials chosen by provider (0.010) Printed materials, patient’s choice (0.009)
Double vision	Group session with eye care provider (0.041) Group session with eye health educator (0.046) Videos of lectures (0.049) Web-based learning modules (0.037)
Glasses and contact lenses	One-on-one session with eye health educator (0.047) Group session with eye health educator (<0.001) Lectures (in-person) (<0.001) Printed materials chosen by provider (<0.001) Printed materials, patient’s choice (<0.001) Websites, recommended by provider (0.002) Web-based learning modules (0.001)
Low vision rehabilitation	Group session with eye care provider (<0.001) One-on-one session with eye health educator (0.003) Group session with eye health educator (0.007) Lectures (in-person) (0.006) Videos of lectures (<0.001) Printed materials, patient’s choice (0.019)
Laser vision corrective surgery	One-on-one session with eye care provider (0.014)
Eyelid surgery and cosmetic procedures of the face	Lectures (in-person) (0.050) Printed materials, patient’s choice (0.011)

Notes: The associated learning practices for each ophthalmic topic are summarized. For example, for cataracts, the respondents who noted an interest in cataracts were compared to those who did not select cataracts. The respondents who were interested in cataracts were more likely to select group session with eye care provider, one‐on‐one session with eye health educator, group session with eye health educator, in‐person lectures, videos of lectures, and printed materials chosen by provider. The differences for each of these learning practices between those interested in cataracts and those who were not were statistically significant with the P‐value <0.05. Only statistically significant associations are listed in the table

* P‐value based on Fisher’s exact test of difference in proportions.

Table 3 Ophthalmic topics of interest and age

	Age Mean, years (SD)		P-value*
	Yes, interested	No, not interested
Cataracts	61 (16)	54 (19)	<0.001
Macular degeneration	63 (14)	54 (19)	<0.001
Glaucoma	59 (16)	54 (20)	0.014
Diabetic retinopathy	58 (15)	55 (19)	0.231
Dry eye	60 (17)	54 (19)	0.006
Double vision	46 (18)	56 (19)	0.003
Glasses and contact lenses	50 (18)	57 (19)	0.002
Low vision	57 (19)	55 (19)	0.553
Laser vision correction	52 (20)	56 (19)	0.163
Droopy eyelids	59 (18)	55 (19)	0.221

Notes: The average age of the respondents who noted an interest in each of the ophthalmic topics are listed. For example: for cataracts, the average age of the respondents who selected “cataracts” as a topic of interest was 61 years old; the average age of those who did not select “cataracts” was 54 years old.

* P‐value based on t‐test of difference between categories for means of age.

Abbreviation: SD, standard deviation.

Table 4 Ophthalmic topics of interest and race

	Race Number of survey respondents (%, within race category)					P-value*
	White 309	Black 112	Hispanic 10	Asian 11	Other 169
Cataracts	67 (22%)	31 (28%)	0	5 (42%)	35 (21%)	0.110
Macular degeneration	59 (19%)	10 (9%)	1 (10%)	4 (33%)	28 (17%)	0.048
Glaucoma	67 (22%)	51 (46%)	0	4 (33%)	45 (27%)	<0.001
Diabetic retinopathy	23 (7%)	35 (31%)	1 (10%)	2 (17%)	22 (13%)	<0.001
Dry eye	50 (16%)	20 (18%)	2 (20%)	3 (25%)	29 (17%)	0.852
Double vision	18 (6%)	12 (11%)	0	0	9 (5%)	0.380
Glasses and contact lenses	51 (17%)	30 (27%)	2 (20%)	3 (25%)	20 (12%)	0.022
Low vision	24 (8%)	22 (20%)	1 (10%)	0	16 (10%)	0.012
Laser vision correction	28 (9%)	18 (16%)	0	2 (17%)	13 (8%)	0.120
Droopy eyelids	23 (7%)	9 (8%)	0	1 (8%)	12 (7%)	0.988

Notes: The racial composition of the respondents who noted an interest in each of the ophthalmic topics are listed. For example: for cataracts, of the respondents who indicated white race, 22% selected “cataracts”; of those who indicated black race, 28% selected “cataracts”; none of the Hispanic respondents selected “cataracts”; of the Asian respondents, 42% selected “cataracts”; and of the respondents who did not indicate a race, 21% selected “cataracts”.

* P‐value based on Fisher’s exact test of differences among proportions.

Table 5 Current route of eye health information: age and racial characterization

	Primary medical doctor	Eye care professional	Duke ophthalmologist optometrist	Internet	Printed educational materials	Television	Friends/family
Age of those who responded
Mean, years (SD)
Yes	54 (18)	58 (17)	59 (18)	49 (17)	57 (17)	54 (18)	51 (20)
No	56 (20)	51 (21)	53 (19)	59 (19)	55 (20)	56 (19)	56 (18)
P-value*	0.130	<0.001	<0.001	<0.001	0.245	0.529	0.012
Race
Number of survey respondents (%, within race category)
White   309	110 (36%)	205 (66%)	144 (47%)	131 (42%)	72 (23%)	38 (12%)	68 (22%)
Black   112	41 (37%)	72 (64%)	47 (42%)	41 (37%)	29 (26%)	28 (25%)	34 (30%)
Hispanic   10	1 (10%)	2 (20%)	3 (30%)	4 (40%)	1 (10%)	3 (30%)	3 (30%)
Asian   11	5 (42%)	6 (50%)	3 (25%)	4 (33%)	3 (25%)	0 (0%)	4 (33%)
Other   169	27 (16%)	35 (21%)	16 (10%)	18 (11%)	10 (6%)	12 (7%)	12 (7%)
P-value**	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001

Notes: The age and racial composition of the survey respondents who noted how they are currently learning about eye diseases are summarized. The survey question was “What are some of the ways you currently learn about eye health and disease? Check all that apply.” For example, for primary medical doctor, the average age of the respondents who noted that they are currently learning about eye diseases from their primary medical doctor was 54 years old; the average age of those who did not select “primary medical doctor” was 56 years old. Of the respondents who indicated White race, 36% selected “primary medical doctor” in answer to this question; of the Black respondents, 37% selected “primary medical doctor”; of the Hispanic respondents, one or 10% selected “primary medical doctor”; of the Asian respondents, 42% selected “primary medical doctor”; and of the respondents who did not indicate a race, 16% selected “primary medical doctor”;

* P‐value based on Student’s t‐test of difference between categories for means of age

** P‐value based on Fisher’s exact test of difference among proportions.

Abbreviation: SD, standard deviation.

Figure 3 Preferred locations for learning about ophthalmic topics.

Notes: The survey question asked “Where do you prefer to learn about eye health and disease? Check all that apply.” Of the subtotal of respondents who noted a preference for the specific topic, the bars represent the percentage of respondents who preferred each location (home/eye center/primary care). For example, for cataracts, 57% of the respondents who noted an interest in cataracts also noted a preference for learning at home, 54% of those respondents noted a preference for the eye center, and 19% noted a preference for the primary care location. The total percentage is greater than 100 because respondents could choose more than one. Overall, survey respondents preferred learning about ophthalmology topics at home and at the eye center. However, about 20% of respondents noted a preference for learning about ophthalmology topics at the primary care doctor’s office, particularly concerning the topics of low vision and laser vision correction, with one in three respondents noting the preference for primary care.

Figure S1 Duke eye center patient survey.

Abbreviations: LASIK, laser‐assisted in situ keratomileusis; PCP, primary care provider.