Beyond intraocular pressure: Optimizing patient-reported outcomes in glaucoma.

Area of Science:

• Ophthalmology
• Public Health
• Patient-Reported Outcomes Research

Background:

• Glaucoma is a leading cause of irreversible blindness globally, affecting over 3% of adults over 40.
• Elevated intraocular pressure (IOP) is a primary risk factor, managed via medications, laser, or surgery.
• Patient-centered outcomes (PCOs) like daily functioning and emotional well-being are critical but often overlooked.

Purpose of the Study:

• To critique current glaucoma-specific patient-centered outcome measures (PCOMs) and patient-reported outcome measures (PROMs).
• To identify limitations in existing outcome measures for assessing glaucoma treatment effectiveness.
• To propose advanced methods for improving patient outcome monitoring in glaucoma care.

Main Methods:

• Non-systematic review and critique of psychometric properties of existing glaucoma PCOMs and PROMs.
• Analysis of PCOM and PROM data to understand impacts on patient functioning and well-being.
• Exploration of item banking and computerized adaptive testing (CAT) as potential solutions.

Main Results:

• Studies using PCOMs show glaucoma patients face mobility, navigation, and visual processing challenges.
• PROMs reveal significant negative impacts of glaucoma on visual function, mobility, independence, and emotional well-being.
• Current PROMs often lack sensitivity, appropriate selection, and adequate follow-up for effective glaucoma management, especially in early stages.

Conclusions:

• Current glaucoma treatment effectiveness from a patient-centered perspective is uncertain due to methodological limitations.
• Item banking and CAT offer promising solutions to overcome PROM limitations, enabling customized administration and improved healthcare outcomes.
• There is a need for more robust, sensitive, and patient-centered outcome measures in glaucoma research and clinical practice.