Patients Who Are Black Show Hesitancy in Asking Glaucoma-Related Questions

Patients who are Black and have a glaucoma diagnosis may not ask their doctor questions pertaining to their condition or medications despite expressing their concerns on a pre visit question prompt list, according to a study published in Eye.

Researchers enrolled 189 individuals (100% Black) from 3 glaucoma practices in a randomized controlled trial and randomly assigned participants to usual care or an intervention (n=93) involving a video encouraging patients to become more involved in their care and pre visit question prompt lists. All study participants had glaucoma and reported non adherence to glaucoma medications. The team identified questions from the prompt list that were of most interest to patients who are Black and determined whether they asked those questions during clinical visits.

Overall, patients checked an average 6.77 questions on the prompt list, but asked a mean 1.87 of those questions, the report shows. Among individuals who checked at least 1 question, 54.8% asked their provider at least one of the questions they had checked. 

On the prompt list, participants most frequently asked whether they were going to go blind (58.1%), what an ideal intraocular pressure (IOP) for them would be (45.2%), and what the causes of glaucoma were (40.9%). The most commonly asked questions during face-to-face visits involved inquiries as to what time of day and how often glaucoma medications should be administered. While 18 and 6 participants checked these items on their prompt lists, 9 and 3, respectively, asked the clinician these questions during an in-person interaction.

The study authors suggest that research needs to determine why patients who are Black do not ask clinicians questions they may want answers to and explain, “[m]ore can be done by providers to increase patient comfort with asking disease state and medication-related questions during their visits, especially in conjunction with prompt list interventions.”

Study limitations include a small sample size and potential geographic bias due to recruitment from 2 US states.