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Views of Glaucoma Patients on Aspects of Their Treatment: An Assessment of Patient Preference by Conjoint Analysis

¹From the Department of Ophthalmology, Queen’s Medical Centre, Nottingham, United Kingdom; and the ²Division of Primary Care, University of Nottingham, Nottingham, United Kingdom.

PURPOSE. To determine by conjoint analysis which factors in the management and treatment of glaucoma were of most importance to patients and to relate these factors to the patient’s clinical glaucoma condition.

METHODS. An interview-based study was performed. Demographic and visual function data are recorded. Participants completed the Visual Function Questionnaire-25 and ranked 10 hypothetical patient scenarios that contained different risks of moderate visual loss, postoperative complications, long-term blindness, use of topical medication, and glaucoma surgery. Conjoint analysis was performed to determine the relative importance of these factors for individuals and the group as a whole.

RESULTS. Eighty-two patients were interviewed from two consultants’ outpatient clinics. Forty-five were male and 37 female. Seventy-nine were white. The most important factors to patients with glaucoma were the risk of moderate visual impairment and the risk of blindness, with an importance of 38% and 27%, respectively. The use of topical medication had an importance of 11%. Proceeding to surgical intervention (trabeculectomy) had an importance of 15%, and the small risk of visual deterioration after surgery (trabeculectomy) had an importance of 9%.

CONCLUSIONS. To patients, the most important factors regarding glaucoma and its treatment are the risks of moderate visual loss (the ability to continue to drive) and long-term blindness. The treatment methods used are of much less importance.

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