Barriers to adoption of a personal health record in an ophthalmic setting: lessons from implementation of a Glaucoma Patient Passport

• Published in: Clinical ophthalmology (Auckland, N.Z.) Vol. 13; pp. 1369 - 1375
• Main Authors: Badran, Imad, Bruynseels, Alice, Khan, Salim, Sii, Freda, Shah, Peter
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01-07-2019; Taylor & Francis Ltd; Dove; Dove Medical Press
• Subjects: Activities of daily living; Asthma; Attitudes; Care and treatment; Chronic disease; Chronic diseases; Chronic illnesses; Clinical outcomes; Diabetes; Ethnicity; Glaucoma; Hospitals; Medical records; Medical research; Methods; Ophthalmology; Original Research; Passports; patient passport; Patients; Personal health; Qualitative research; Questionnaires; R&D; Research & development; Self care (Health); self-care; Workloads; United Kingdom; United Kingdom > UK; ophthalmology; patient passport; chronic disease; self-care
• ISSN: 1177-5467; 1177-5483; 1177-5483
• DOI: 10.2147/OPTH.S208377

Self-care in chronic disease is increasingly important. In glaucoma services, there is an unmet need for a self-care tool such as a patient passport. This study aims to evaluate adoption of a new self-care tool, the Glaucoma Patient Passport (GPP) within a tertiary hospital glaucoma service.
The GPP was designed following consultation exercises between patients and clinicians at the first and second UK National Glaucoma Think Tanks. A patient questionnaire, comprising a mixed methods quantitative and qualitative research approach was used to explore the utility of GPP, patient attitude to GPP and barriers to adoption, 6 months after GPP receipt.
GPP feedback was received from 62 patients. On-going utilization of the GPP after receipt was high, at 84%, with patients most commonly using the GPP at home, to "look for information." Seventy-three percent reported improved knowledge of glaucoma care since using the GPP, with two-thirds (63%) reporting that the GPP had improved their glaucoma care. Three main themes were identified in exploring barriers to GPP adoption; clinician involvement in GPP use, GPP size, and GPP use in visual impairment.
Implementation and adoption of the world's first GPP were a success. GPP utility was high and patient attitudes were predominantly positive, with improved self-care. However, several areas were identified for future GPP improvement. The GPP has the potential to improve patient self-care in glaucoma, bridging the care gap created by the increased workload in glaucoma services.