A United Kingdom study of glaucoma patients has found ethnicity is strongly associated with differing perceptions about the health outcomes that matter.
The study, published in BMJ Open,1 involved 511 patients from a highly diverse population diagnosed with open-angle glaucoma or ocular hypertension. All had already experienced treatment (eye drops, laser or surgery) to lower intraocular pressure (IOP).
Participants were asked to rank the priority of outcomes from multiple small subsets. These self-reported priorities for health outcomes ultimately fell into one of four clusters: vision, drop freedom, IOP, or one-time treatment.
The study authors found ethnicity was the strongest determinant of cluster membership after adjusting for potential confounders.
… minority ethnic groups may have differing expectations of the outcomes of care compared with their white counterparts.
They found that compared with white patients whose priority was vision alone, “the odds ratio (OR) for black/black British patients was 7.31 (95% confidence interval (CI) 3.43–15.57, P < .001) for prioritising drop freedom; 5.95 (2.91-12.16, P < .001) for IOP; and 2.99 (1.44-6.18, P = .003) for one-time treatment.”
Compared with white patients, among Asian/Asian British patients, the OR was 3.17 (1.12-8.96, P = .030) for prioritising IOP as highly as vision. Other ethnic minority groups chose other health outcomes over vision, with ORs of 4.50 (1.03-19.63, P = .045) for drop freedom and 5.37 (1.47-19.60, P = .011) for IOP.
Differing Expectations
“We identified major racial and ethnic disparities in personal priorities, showing for the first time that minority ethnic groups may have differing expectations of the outcomes of care compared with their white counterparts.
“These differences need to be considered if racial disparities in health outcomes are to be understood and hence equitably addressed,” the authors wrote.
The authors said it was unknown whether ethnic disparities in priorities for health outcomes exist in other specialisms of healthcare. They said it would also be important to determine whether health priorities differ in other geographic regions, or whether individual preferences are stable with time.
Reference
- Safitri A, Konstantakopoulou E, Gazzard G, et al. Priorities for health outcomes in glaucoma in an ethnically diverse UK cohort: an observational study. BMJ Open. 2024;14:e081998. doi: 10.1136/bmjopen-2023-081998.
