Gupta (Slota) C, Blalock SJ, Carpenter DM, Robin AL, Muir KW, Sleath B. Examining patient provider communication regarding cost in the glaucoma patient population. Poster presented at the 2014 ISPOR 19th Annual International Meeting; May 2014. Montreal, Canada. [abstract] Value Health. 2014 May; 17(3):A287.


OBJECTIVES: Adherence to medications is a significant problem in glaucoma patients. Costs of medications have frequently been cited as barriers to adherence. This study aims to identify the extent of physician-patient communication concerning medication cost during glaucoma medical visits. The study also aims to examine ophthalmologist and patient characteristics that influence whether the ophthalmologist discusses medication costs with the patient during glaucoma medical visits.

METHODS: English-speaking adults with glaucoma and their ophthalmologists at six geographically diverse ophthalmology practices were recruited for the study. All visits were videotape recorded and transcribed verbatim. Patients were interviewed following their office visit. A research assistant reviewed the patient’s medical records noting comorbidities, glaucoma medication use, and glaucoma severity. Ophthalmologists completed a demographic survey. Transcripts were coded to identify whether the ophthalmologist discussed medication cost with the patient during the office visit. Bivariate analyses were performed to examine whether ophthalmologist and patient characteristics were associated with discussion of medication cost.

RESULTS: Fifteen ophthalmologists and 279 of their glaucoma patients participated in the study. Ophthalmologists discussed medication costs during only 67 (24%) of glaucoma medical visits. Ophthalmologists with more years of experience practicing were significantly more likely to discuss medication cost (p< 0.03). Also, ophthalmologists were significantly more likely to discuss medication cost with patients who had higher levels of formal education, were new to using glaucoma medications, and were taking more glaucoma medications (p< 0.05).

CONCLUSIONS: Ophthalmologists do not routinely discuss medication cost during glaucoma patient office visits. Future research is needed to investigate the impact of physician-patient communication concerning medication cost on adherence in the glaucoma patient population.

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