Glaucoma patient experiences during the COVID-19 pandemic: Changing selfperceived outcomes of care as assessed by the POEM questionnaire

ABSTRACT

Purpose: COVID-19 continues to disrupt the delivery of ophthalmic care in the third wave of the pandemic. Increased rates of anxiety has been reported in patient cohorts as COVID-19 impacts patients' hospital perceptions and has upended the patient experience. We sought to assess the impacts of COVID-19 on glaucoma patient self-perceived outcomes and experiences as assessed by the POEM questionnaire. Methods: 126 consecutive patients attending a tertiary clinic over a 2-week period were surveyed with the Patient Reported Outcome and Experience measure (POEM). POEM is an 8-item questionnaire that addresses aspects of outcome (acceptability of treatment, fear of blindness, impact on daily life), and aspects of experience (safety, understanding, organization of care). The questionnaire was modified to determine if each item was more of a concern during the COVID pandemic. Assessments were performed in September 2020 and results were compared to pre-COVID survey results (n= 780). The questionnaires were conducted anonymously with no pairing to clinical data or demographics attempted. Results: Survey results showed that the items showing the biggest reduction in agreement pertained to the understanding of how glaucoma is treated and patients' perception of their treatment team. There was a a 10-15% decrease in agreement for Q2 (I understand how my eye problem is managed), Q4 (I think my glaucoma is not getting worse), Q7 (I feel safe under the care of my glaucoma team) and Q8 (My glaucoma care is well organized) compared to pre COVID-19 questionnaire findings. Patients identified Q6 (I'm not worried about losing vision from glaucoma), Q7 (I feel safe under the care of my glaucoma team) and Q8 (My glaucoma care is well organized) as the most common aspects of their glaucoma care that COVID has increased concern over with 28.8%, 32.1% and 40.2% giving 'yes' responses respectively. Conclusions: The COVID-19 pandemic has resulted in an increased uncertainty amongst patients about how their glaucoma is managed. Patients may not feel as safe about their glaucoma care and heightened anxiety about losing vision are issues which need to be addressed. Further studies investigating the patient experience and outcomes are required to fully elucidate the true psychological and physiological impacts of COVID-19.