Self-Monitoring Symptoms in Glaucoma: A Feasibility Study of a Web-Based Diary Tool

Abstract

Purpose. Glaucoma patients annually spend only a few hours in an eye clinic but spend more than 5000 waking hours engaged in everything else. We propose that patients could self-monitor changes in visual symptoms providing valuable between clinic information; we test the hypothesis that this is feasible using a web-based diary tool. Methods. Ten glaucoma patients with a range of visual field loss took part in an eight-week pilot study. After completing a series of baseline tests, volunteers were prompted to monitor symptoms every three days and complete a diary about their vision during daily life using a bespoke web-based diary tool. Response to an end of a study questionnaire about the usefulness of the exercise was a main outcome measure. Results. Eight of the 10 patients rated the monitoring scheme to be “valuable” or “very valuable.” Completion rate to items was excellent (96%). Themes from a qualitative synthesis of the diary entries related to behavioural aspects of glaucoma. One patient concluded that a constant focus on monitoring symptoms led to negative feelings. Conclusions. A web-based diary tool for monitoring self-reported glaucoma symptoms is practically feasible. The tool must be carefully designed to ensure participants are benefitting, and it is not increasing anxiety.

Acceptability of a home-based visual field test (Eyecatcher) for glaucoma home monitoring: a qualitative study of patients’ views and experiences

“…Evidence suggests direct release of test results is associated with increased healthcare engagement. 43 However, unintended consequences which must be considered include increased anxiety regarding unusual results, 13 and the ethical implications of providing complex clinical data outside of a hospital or clinic environment, where queries cannot be addressed promptly. This problem is arguably more acute in glaucoma due to the large amount of technical detail provided in each VF report, interpretation of which requires specialist knowledge.…”

“…Previous research suggests people with glaucoma are receptive to forms of home monitoring, such as web-based symptom diaries. 13 However, the acceptability of home-based VF testing has not been explored. This research gap is significant as integration of new healthcare approaches can be challenging and sometimes met with resistance from service users.…”

Patient satisfaction with care in an urban tertiary referral academic glaucoma clinic in the US

“…Future directions for research into improving the care experience of glaucoma patients include identifying methods to monitor visual changes and glaucoma progression through remote web-based technology such as telemedicine and online tools. 39 , 40 …”

Lessons learned from the development and implementation of a patient-reported outcome and experience measure (POEM) in an Australian glaucoma practice

“…With further use of the POEM on a larger glaucoma population, the validity, consistency and reliability of the tool could be better evaluated. Follow up administration of the POEM to the same population over time also could detect whether changes to the system have been effective in improving the quality of care [21].…”