WED-110 - Rural Patients’ Experiences of Glaucoma Self-management Practices

Brief Abstract Summary: Attendees will learn about self-care strategies used by rural glaucoma patients to manage their condition in their everyday lives. They will also learn about various preventive, protective and restorative behaviors of glaucoma patients for everyday self-management of glaucoma despite facing barriers such as transportation challenges and difficulties in sustaining self-management behaviors. Additionally, they will recognize the need for patient-centered interventions to reduce logistic barriers and support patients to sustain and integrate self-management behaviors to manage glaucoma and prevent vision loss.

Detailed abstract description:

Background:
Glaucoma, a chronic eye condition, requires lifelong management and care to prevent vision loss. While pharmacotherapy is integral part of glaucoma care, patients often need to integrate additional health behaviors to prevent blindness. There is a dearth of qualitative studies exploring how glaucoma patients manage their condition in their everyday lives, espeically in rural West Virginia, which bears a disproportionate shortage of healthcare providers.

Aim:
To explore the self-care strategies that rural patients with glaucoma use to manage their condition in their everyday lives in West Virginia.

Methods:
As part of a larger study, 29 glaucoma patients were recruited at the WVU Eye Institute via phone calls made 1-2 days prior to their appointment (IRB protocol number: 2311878165). Interested individuals completed the informed consent prior to completing the semi-structured interviews. Interviews were conducted using an IRB-approved interview guide at a private space and were recorded. Interviews were transcribed and checked for accuracy. Two qualitative researchers initially coded two transcripts independently to reach consensus and finalize the codebook. All transcripts were then coded using the codebook and discrepancies in coding were resolved prior to forming themes and sub-themes. Braun and Clark’s thematic analysis was used.

Results:
Several key themes emerged from the analysis:
1. Medication adherence: Patients described routines to ensure that they use the eye drops as prescribed by their doctors. They also described using moisture drops to relieve dryness and discomfort.
2. Active engagement in care: Patients described being consistent with their appointments and follow-up visits with their doctors. However, some patients mentioned transportation being a major inconvenience and source of discomfort for timely follow-up visits and described that they would prefer if the point of care did not require long commute.
3. Lifestyle adjustments: Patients described various lifestyle adjustments such as being vigilant in providing rest to their eyes, shielding eyes from dust, injury, glare and sunlight. Many described difficulties in consistently practising these adjustments because of practical issues.

Conclusion:
Glaucoma patients employed several preventive, protective and restorative behaviors to manage their glaucoma. Despite strong motivation to preserve their vision, many face structural barriers such as transportation challenges and practical difficulties in sustaining lifestyle adjustments. These findings emphasize the importance of patient-centered interventions to address logistic barriers and support patients to sustain glaucoma self-management behaviors in their everyday lives.