Priorities for health outcomes in glaucoma in an ethnically diverse UK cohort: an observational study

Abstract

Objectives To assess whether patients from minority ethnic groups have different perceptions about the quality-of-life outcomes that matter most to them.Design Cross-sectional observational study.Setting High volume eye centres serving the most ethnically diverse region in the UK, recruiting from July 2021 to February 2022.Participants 511 patients with primary open-angle glaucoma and the predisease state of ocular hypertension.Main outcome measures The main outcome was participants’ self-reported priorities for health outcomes.Results Participants fell into one of four clusters with differing priorities for health outcomes, namely: (1) vision, (2) drop freedom, (3) intraocular pressure and (4) one-time treatment. Ethnicity was the strongest determinant of cluster membership after adjusting for potential confounders. Compared with white patients prioritising vision alone, the OR for black/black British patients was 7.31 (95% CI 3.43 to 15.57, p<0.001) for prioritising drop freedom; 5.95 (2.91 to 12.16, p<0.001) for intraocular pressure; and 2.99 (1.44 to 6.18, p=0.003) for one-time treatment. For Asian/Asian British patients, the OR was 3.17 (1.12 to 8.96, p=0.030) for prioritising intraocular pressure as highly as vision. Other ethnic minority groups also had higher ORs for prioritising health outcomes other than vision alone: 4.50 (1.03 to 19.63, p=0.045) for drop freedom and 5.37 (1.47 to 19.60, p=0.011) for intraocular pressure.Conclusions Ethnicity is strongly associated with differing perceptions about the health outcomes that matter. An individualised and ethnically inclusive approach is needed when selecting and evaluating treatments in clinical and research settings.