Development of the conceptual framework for the Eye-Drop Satisfaction Questionnaire (EDSQ) in glaucoma using a qualitative study

• Published in: BMC health services research 2007-08, Vol.7 (1), p.124-124, Article 124
• Main Authors: Nordmann, Jean-Philippe, Denis, Philippe, Vigneux, Marc, Trudeau, Elyse, Guillemin, Isabelle, Berdeaux, Gilles
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Antihypertensive Agents - administration & dosage; Antihypertensive Agents - therapeutic use; Care and treatment; Complications and side effects; Diagnosis; Evaluation; Female; France; Glaucoma; Glaucoma, Open-Angle - drug therapy; Glaucoma, Open-Angle - economics; Humans; Intraocular pressure; Male; Middle Aged; Motivation; Open-angle glaucoma; Ophthalmic Solutions - administration & dosage; Ophthalmic Solutions - therapeutic use; Patient Compliance - psychology; Patient education; Patient Education as Topic; Patient Satisfaction - statistics & numerical data; Physician-Patient Relations; Qualitative Research; Risk Factors; Socioeconomic Factors; Surveys and Questionnaires; United Kingdom
• ISSN: 1472-6963; 1472-6963
• DOI: 10.1186/1472-6963-7-124

Compliance is a major issue in glaucoma care. It is usually poor in glaucomatous patients, and may ultimately result in an acceleration of the disease progression and a risk of blindness. Reasons for this poor compliance are complex and multifactorial, amongst which patient satisfaction can be counted. The objective of this study was to develop a questionnaire to assess patient satisfaction and compliance with eye-drop treatment. A qualitative study was carried out to develop the questionnaire. An interview guide was developed based on a literature review. Structured interviews of fifteen French and English patients with primary open-angle glaucoma or intraocular hypertension were conducted by trained interviewers of the native language of the interviewees. General concepts and subconcepts were identified from the transcripts. The questionnaire was developed using the patient verbatim, and submitted to six patients (French and English) for cognitive debriefing. Following patients' comments, items were modified and restructured, and a pilot questionnaire was designed. Analysis of data from the interviews with patients and clinicians resulted in the elicitation of concepts related to patient satisfaction and compliance with glaucomatous treatment. These were further refined and used to generate a test questionnaire, which consisted of 46 items grouped into 6 domains: patient characteristics, treatment characteristics, patient-clinician relationship, patient experience with the disease and the treatment, interaction between the patient and the treatment, and patient knowledge of the disease and the treatment. The Eye-Drop Satisfaction Questionnaire (EDSQ) conceptual framework and items were developed simultaneously in French and in English. This questionnaire could be used to evaluate patient satisfaction and compliance with eye-drop treatment and would facilitate the identification of patients at risk of being non-compliant prior to clinical trials or innovative device tests. A psychometric study is under way to validate the questionnaire.