Barriers to Care among Glaucoma Patients With a Missed Appointment and Interest in a Navigator Program

Abstract

Precis: Most glaucoma patients with a missed appointment report barriers to care and social risk factors. One-third expressed interest in engaging with a patient navigator program. Most expressed interest in rescheduling. Purpose: To identify barriers to care among glaucoma patients with a missed appointment and to assess their interest in a patient navigator program. Patients and Methods: A cross-sectional study involving adult glaucoma patients from an academic eye center who missed their scheduled appointment between April 18 and July 25, 2022. Participants were surveyed about reasons for missed appointments, barriers to care, social risk factors, and interest in consulting with our patient navigator program. Results: Of 172 patients with a missed glaucoma appointment, 73% (126/172) were contacted and 40% (51/126) of those completed the survey. Participant age averaged 67±14 years, half were female (25/51, 49%), and most identified as Black (27/51, 53%) or White (21/51, 40%). Barriers to seeing a doctor including difficulty scheduling appointments (13/51, 26%), transportation (12/51, 24%), and cost or insurance barriers (8/51, 16%). Twenty-eight (55%) respondents reported at least one social risk factor. A positive association was found between having at least one risk factor and expressing interest in consulting our patient navigator (OR=6.7, P=0.009). Overall, a third of respondents expressed interest in engaging with our patient navigator program (17/51, 33%). Two-thirds of participants reported awareness of missed appointments (34/51, 67%), of whom 35% (12/34) reported having already rescheduled, 41% (14/34) expressed interest in rescheduling, and 24% (8/34) did not wish to return. Conclusion: Glaucoma patients with a missed appointment report barriers to care and face social risk factors. Telephone outreach may help to re-engage them with care, and patients expressed interest in a patient navigator program to address social needs.