Which Quality of Life Score is Best for Glaucoma Patients and Why?
Which Quality of Life Score is Best for Glaucoma Patients and Why?
Background: The glaucomas are generally asymptomatic diseases until they are very advanced. They affect 2% of the population over 40 years of age and therefore represent a significant public health issue. There have been a number of attempts to develop quality of life scales for the disease. This review discusses the pros and cons of these scales and suggests the best of the current ones for use in a clinical setting.
Methods: Medline, Embase and Google Scholar were searched for relevant articles. No time period was defined and all types of article were included.
Results: 11 Quality of Life scores were identified that have been used with glaucoma patients.
Conclusion: There is no generally accepted 'best' Quality of Life instrument for use in glaucoma. Many of the scales are biased towards physical symptoms and do little to address the personal or social factors of the disease. Further work is needed to produce scales that address all these areas as well as being simple to administer in a clinical setting.
Glaucoma is the term given to the chronic, debilitating, progressive group of eye disorders that can lead to visual field loss and blindness. Glaucoma usually produces certain characteristic visual field defects in the individual's peripheral, as well as central vision. Due to the intractable nature of the disease the patient usually spends, following diagnosis, the rest of their life attending an eye hospital and taking frequent (daily) ocular anti-hypertensive medication. The treatment has associated side effects, it is expensive and often inconvenient to instill. It has been reported that approximately 67 million patients suffer from glaucoma and roughly 10% of these are blind. It is therefore not surprising that glaucoma frequently has a large impact on a patient's quality of life.
The diagnosis of glaucoma affects people in different ways. Some readily accept the diagnosis and are keen to seek out information. Others are more ignorant and disappear into the community, only to return years later with a marked deterioration in their visual function. Most patients fall in between the two extremes and adhere to their treatment in the main with little or no understanding of the disease process.
Physicians have long strived to quantify quality of life (QoL) in patients with glaucoma. The reasons for this range from understanding of the patients experience of the disease to the measurement of outcomes in treatment trials. However although a number of instruments have been used/developed it has proved difficult to develop the idea glaucoma QoL score. Patients can lose quality of life for a number of reasons. The distress of the diagnosis, the insidious loss of vision and independence, the problems with frequent treatment and regular hospital outpatient appointment reviews. So how do we assess the impact of the disease on the patient's quality of life? Does the QoL of life score need to be all encompassing? Should it include all aspects of the disease process from diagnosis to death? Unfortunately the QoL scales can be complicated, non user-friendly and contain a myriad of complex mathematics. The aim of this article is to give a narrative review of the readily available QoL scales, highlight the strengths and weaknesses of each and suggest which one we find "best" for our assessing glaucoma patients in clinical practice.
Abstract and Which Quality of Life Score is Best for Glaucoma Patients and Why?
Abstract
Background: The glaucomas are generally asymptomatic diseases until they are very advanced. They affect 2% of the population over 40 years of age and therefore represent a significant public health issue. There have been a number of attempts to develop quality of life scales for the disease. This review discusses the pros and cons of these scales and suggests the best of the current ones for use in a clinical setting.
Methods: Medline, Embase and Google Scholar were searched for relevant articles. No time period was defined and all types of article were included.
Results: 11 Quality of Life scores were identified that have been used with glaucoma patients.
Conclusion: There is no generally accepted 'best' Quality of Life instrument for use in glaucoma. Many of the scales are biased towards physical symptoms and do little to address the personal or social factors of the disease. Further work is needed to produce scales that address all these areas as well as being simple to administer in a clinical setting.
Which Quality of Life Score is Best for Glaucoma Patients and Why?
Glaucoma is the term given to the chronic, debilitating, progressive group of eye disorders that can lead to visual field loss and blindness. Glaucoma usually produces certain characteristic visual field defects in the individual's peripheral, as well as central vision. Due to the intractable nature of the disease the patient usually spends, following diagnosis, the rest of their life attending an eye hospital and taking frequent (daily) ocular anti-hypertensive medication. The treatment has associated side effects, it is expensive and often inconvenient to instill. It has been reported that approximately 67 million patients suffer from glaucoma and roughly 10% of these are blind. It is therefore not surprising that glaucoma frequently has a large impact on a patient's quality of life.
The diagnosis of glaucoma affects people in different ways. Some readily accept the diagnosis and are keen to seek out information. Others are more ignorant and disappear into the community, only to return years later with a marked deterioration in their visual function. Most patients fall in between the two extremes and adhere to their treatment in the main with little or no understanding of the disease process.
Physicians have long strived to quantify quality of life (QoL) in patients with glaucoma. The reasons for this range from understanding of the patients experience of the disease to the measurement of outcomes in treatment trials. However although a number of instruments have been used/developed it has proved difficult to develop the idea glaucoma QoL score. Patients can lose quality of life for a number of reasons. The distress of the diagnosis, the insidious loss of vision and independence, the problems with frequent treatment and regular hospital outpatient appointment reviews. So how do we assess the impact of the disease on the patient's quality of life? Does the QoL of life score need to be all encompassing? Should it include all aspects of the disease process from diagnosis to death? Unfortunately the QoL scales can be complicated, non user-friendly and contain a myriad of complex mathematics. The aim of this article is to give a narrative review of the readily available QoL scales, highlight the strengths and weaknesses of each and suggest which one we find "best" for our assessing glaucoma patients in clinical practice.
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