Impact of a Social Worker in a Glaucoma Eye Care Service: A Prospective Study

Hark, Lisa A; Madhava, Malika; Radakrishnan, Anjithaa; Anderson-Quiñones, Catherine; Robinson, Debra; Adeghate, Jennifer; Silva, Stephen; Adepoju, Tomilade; Dave, Yatee A.; Fudemberg, Scott J.

doi:10.1093/hsw/hly038

Cited by 12 publications

(16 citation statements)

References 22 publications

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“…In ophthalmology, a community-based study found that use of a patient navigator improved appointment follow-up rates after screening for glaucoma [ 57 ]. Similarly, a social worker intervention in eye clinic settings effectively addressed barriers for most patients and reduced patient distress [ 58 , 59 ].…”

Section: How Ophthalmologists Can Take Action To Address Social Needsmentioning

confidence: 99%

“…Our patient navigator receives dozens of referrals a month and connects patients with local resources for a wide variety of needs, including arranging home safety assessments for the visually impaired, providing transportation, and connecting patients in need with disability benefits. Incorporating a patient navigator or social worker in the eye clinic may improve medication adherence and reduce loss to follow-up by addressing financial and logistical barriers to care [ 59 ]. Ultimately, these services may improve vision outcomes by reducing social barriers and allowing patients to receive continued treatment.…”

Section: How Ophthalmologists Can Take Action To Address Social Needsmentioning

confidence: 99%

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Addressing Social Determinants of Vision Health

Williams

Sahel

2022

Ophthalmol Ther

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Social determinants of health encompass the quality of an individual’s social and physical environment and its effect on health outcomes. Disparities in these social and environmental factors have a significant role in vision health disparities and inequity in eye care. In this review, we discuss how disparities in visual impairment and eye care utilization are affected by each of the five core domains of social determinants of health, namely economic stability (income, employment, and food security), education (education level and health literacy), health care access (insurance and medical costs), neighborhood environment (housing conditions, home ownership, pollution, and crime), and social context (race and racism). Moreover, we describe a framework by which ophthalmologists can take action to address social determinants of vision health. These actionable strategies are guided by recommendations from the National Academies of Sciences, Engineering, and Medicine and have five complementary components to address social needs: awareness (screening for social needs), assistance (connecting patients with social care resources), adjustment (altering clinical care in recognition of social needs), alignment (understanding social assets and collaborating with community organizations), and advocacy (promoting policies to address social needs). Addressing social determinants of health is complex but achievable through collaborative strategies. Ophthalmologists have an important leadership role in addressing eye care disparities by taking action on underlying social determinants of vision health.

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Section: How Ophthalmologists Can Take Action To Address Social Needsmentioning

confidence: 99%

Section: How Ophthalmologists Can Take Action To Address Social Needsmentioning

confidence: 99%

Addressing Social Determinants of Vision Health

Williams

Sahel

2022

Ophthalmol Ther

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“… 2 – 5 Similar prevalence was noted for other common ophthalmic disorders such as dry eyes. 6 The presence of psychiatric distress in ophthalmic disorders is associated with worse medication and follow-up adherence, 7 disease comprehension, 8 and vision-related quality of life, 9 as well as increased morbidity 10 and health care costs. 11 …”

Section: Introductionmentioning

confidence: 99%

A Framework for Automating Psychiatric Distress Screening in Ophthalmology Clinics Using an EHR-Derived AI Algorithm

Berchuck

Jammal

Page

et al. 2022

Trans. Vis. Sci. Tech.

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Purpose In patients with ophthalmic disorders, psychosocial risk factors play an important role in morbidity and mortality. Proper and early psychiatric screening can result in prompt intervention and mitigate its impact. Because screening is resource intensive, we developed a framework for automating screening using an electronic health record (EHR)-derived artificial intelligence (AI) algorithm. Methods Subjects came from the Duke Ophthalmic Registry, a retrospective EHR database for the Duke Eye Center. Inclusion criteria included at least two encounters and a minimum of 1 year of follow-up. Presence of distress was defined at the encounter level using a computable phenotype. Risk factors included available EHR history. At each encounter, risk factors were used to discriminate psychiatric status. Model performance was evaluated using area under the receiver operating characteristic (ROC) curve and area under the precision–recall curve (PR AUC). Variable importance was presented using odds ratios (ORs). Results Our cohort included 358,135 encounters from 40,326 patients with an average of nine encounters per patient over 4 years. The ROC and PR AUC were 0.91 and 0.55, respectively. Of the top 25 predictors, the majority were related to existing distress, but some indicated stressful conditions, including chemotherapy (OR = 1.36), esophageal disorders (OR = 1.31), central pain syndrome (OR = 1.25), and headaches (OR = 1.24). Conclusions Psychiatric distress in ophthalmology patients can be monitored passively using an AI algorithm trained on existing EHR data. Translational Relevance When paired with an effective referral and treatment program, such algorithms may improve health outcomes in ophthalmology.

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“…Social workers assess, track, and lessen psychosocial barriers to care to improve quality of life and patient well-being (7,18). Social workers not only help patients navigate the health care system; they also provide emotional support, which has been shown to increase appointment adherence (18)(19)(20). In one study, a medical social worker in a pediatric ophthalmology setting increased appointment adherence by 45% (19,20).…”

Section: Introductionmentioning

confidence: 99%

“…Social workers not only help patients navigate the health care system; they also provide emotional support, which has been shown to increase appointment adherence (18)(19)(20). In one study, a medical social worker in a pediatric ophthalmology setting increased appointment adherence by 45% (19,20). In several observational studies, glaucoma patients reported that a social worker resolved their issues and supported their keeping appointments with their ophthalmologist (7,21).…”

Section: Introductionmentioning

confidence: 99%

A Randomized Trial to Improve Adherence to Follow-up Eye Examinations Among People With Glaucoma

et al. 2021

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What is already known on this topic? Nonadherence to follow-up eye care is common among people with glaucoma and other eye diseases. Use of patient navigators and social workers can increase adherence to eye care appointments. What is added by this report?The results of a randomized, controlled trial of patients with glaucoma and other eye diseases showed that a patient navigation and social work intervention doubled the rate of follow-up adherence in community settings.What are the implications for public health practice?Involving patient navigators and social workers in ophthalmic care could improve care and reduce disease progression.

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Impact of a Social Worker in a Glaucoma Eye Care Service: A Prospective Study

Cited by 12 publications

References 22 publications

Addressing Social Determinants of Vision Health

Addressing Social Determinants of Vision Health

A Framework for Automating Psychiatric Distress Screening in Ophthalmology Clinics Using an EHR-Derived AI Algorithm

A Randomized Trial to Improve Adherence to Follow-up Eye Examinations Among People With Glaucoma

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