Understanding the reasons for loss to follow-up in patients with glaucoma at a tertiary referral teaching hospital in Korea

Background/aims To assess the reasons and factors for discontinuation of follow-up among patients with glaucoma at a tertiary referral teaching hospital in Seoul, Korea. Methods We identified all adult patients with glaucoma (>= 18 years), who had visited the glaucoma clinic of Seoul National University Hospital between April 2012 and March 2014 and had missed an appointment by at least 12 months. These patients were traced via cellular phone, and their true status and reasons for discontinuation of follow-up were documented. Results A total of 6848 patients with glaucoma (3512 men and 3336 women) were considered. Among them, 247 (3.61%) had missed a scheduled appointment by 12 months or more. Among 230 (93.1%) who were successfully traced, 4 (1.7%) had died and 96 (41.7%) had self-transferred to another glaucoma clinic. Of the 130 patients left, 123 (94.6%) had treatment and follow-up interruptions, and 7 (5.4%) had been treated with alternative medicine. The two main reasons cited for treatment and follow-up interruptions were lack of understanding regarding the necessity of follow-up (46.3%) and unawareness of appointment schedule (30.9%). In stepwise linear regression analysis, older age (p=0.001. beta=0.13), male gender (p=0.013, beta=0.08) and lower baseline intraocular pressure (p=0.005, beta=0.11) were independently associated with follow-up loss involving treatment interruptions. Conclusions This study's results emphasise the need for ongoing educational support and improved appointment notification, especially for the elderly, men and patients with low baseline intraocular pressure.