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| Dr. Stein crunched the numbers in a national database to learn more about glaucoma treatment. |
One troubling finding: many with glaucoma are not receiving treatment
It appears that many older adults are not getting the treatment they need for a common form of glaucoma, according to a recent study. And perhaps more troubling, the data suggest that both nonwhite and low income individuals are less likely to receive treatment.
For glaucoma specialist and author of the study Joshua D. Stein, M.D., M.S., these numbers are disturbing. Prompt and sustained treatment is essential for preventing loss of vision from glaucoma, a group of eye diseases causing damage to the optic nerve. Once damage occurs, vision loss cannot be restored.
The findings come from an analysis of a database with information on services provided to Medicare beneficiaries over a ten-year period, from 1992 to 2002. Dr. Stein and his colleagues identified 6400 individuals, all 65 years of age or older, who had received a diagnosis of primary open-angle glaucoma (POAG). The most common form of glaucoma, POAG can silently and progressively destroy vision before symptoms are noticed.
The study is one of several of Dr. Stein’s research projects in which he analyzes data from large health care databases to flesh out patterns of health care. For example, by studying large groups he can determine how frequently people use medical services, which medications are prescribed for them, which tests have been ordered, and other factors important in shaping health policy. “There’s a wealth of information available in these data sets,” he explains. “We just need to tap into the data, make sense of the patterns, and, ultimately, use the information to improve care for our patients.”
The current study, published in Ophthalmology, reported that nearly 30 percent of patients with glaucoma received neither medical nor surgical treatment. Dr. Stein further observed that those with Medicaid, a program for needy and low-income individuals, were 43 percent less likely to receive care for glaucoma. Another troubling statistic, he added, is that Hispanics, Asians and patients from other minority groups were all less likely than non-Hispanic whites to receive treatment.
Now, says Dr. Stein, we need further studies to explain why these individuals aren’t receiving proper medical care. “Is access to health care the biggest problem, or is cost the obstacle? Perhaps there are barriers to communication,” he says. The answers to these questions could help more people with glaucoma get the care they need.
The study also examined which glaucoma drugs are most frequently prescribed. And Dr. Stein says there is always debate about new and preferred treatments. But, he adds, “As important as it is to look for new glaucoma therapies, if we could just concentrate on getting people to take advantage of the treatments we already have, we would save a lot of vision.”.
For more information, see the Glaucoma, Cataract, and Anterior Segment Disease Clinic at the Kellogg Eye Center.
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