Article Text

Download PDFPDF
Effects of socioeconomic status on baseline values and outcomes at 24 months in the Treatment of Advanced Glaucoma Study randomised controlled Trial
  1. Anthony J King1,
  2. Jemma Hudson2,
  3. Augusto Azuara-Blanco3,
  4. James F Kirwan4,
  5. Saurabh Goyal5,
  6. Kin Sheng Lim5,
  7. Graeme Maclennan2
  8. TAGS research group
    1. 1Departament of Ophthalmology, Nottingham University Hospitals NHS Trust, Nottingham, UK
    2. 2Centre for Healthcare Randomised Trials (CHaRT), University of Aberdeen Health Services Research Unit, University of Aberdeen, Aberdeen, UK
    3. 3Centre for Public Health, Queen's University Belfast, Belfast, UK
    4. 4Department of Ophthalmology, Queen Alexandra Hospital, Portsmouth, UK
    5. 5Department of Ophthalmology, Guy's and St Thomas' NHS Foundation Trust, London, UK
    1. Correspondence to Anthony J King, Ophthalmology, Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK; Anthony.King{at}nottingham.ac.uk

    Abstract

    Background/aims Socioeconomic status (SES) is associated with late disease presentation and poorer outcomes. We evaluate the effect of SES on treatment outcomes and report the correlation between SES and baseline characteristics of participants in the Treatment of Advanced Glaucoma Study.

    Methods Pragmatic multicentre randomised controlled trial. Four hundred and fifty-three patients presenting with advanced open-angle glaucoma in at least one eye (Hodapp-Parrish-Anderson classification). Participants were randomised to either glaucoma drops (medical arm) or trabeculectomy (surgery arm). Clinical characteristics, Quality of life measurement (QoL) and SES defined by the Index of Multiple Deprivation are reported. Subgroup analysis explored treatment effect modifications of SES at 24 months. Correlation between SES and baseline characteristics was tested with the χ2 test of association for dichotomous variables and pairwise Pearson’s correlation for continuous variables.

    Results The mean visual field mean deviation was −17.2 (6.7)dB for the most deprived quintile of participants and −13.0 (5.5) for the least deprived quintile in the index eye. At diagnosis, there was a strong correlation between SES and ethnicity, age, extent of visual field loss and number of visits to opticians prior to diagnosis. At 24 months, there was no evidence that the treatment effect was moderated by SES.

    Conclusions In patients presenting with advanced glaucoma. SES at baseline is correlated with poorer visual function, poorer Visual Function Questionnaire-25 QoL, ethnicity, age and number visits to an optician in the years preceding diagnosis. SES at baseline does not have an effect of the success of treatment at 24 months.

    Trial registration number ISRCTN56878850.

    • Glaucoma
    • Clinical Trial
    • Epidemiology

    Data availability statement

    Data are available on reasonable request. Two years following publication formal applications can be made to the senior author and will considered by the research team.

    Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Data availability statement

    Data are available on reasonable request. Two years following publication formal applications can be made to the senior author and will considered by the research team.

    View Full Text

    Footnotes

    • Twitter @antonmacanri

    • Collaborators TAGS Research Group:Anthony King, Pavi Agrawal, Richard Stead, David C Broadway, Nick Strouthidis, Shenton Chew, Chelvin Sng, Marta Toth, Gus Gazzard, David Garway-Heath, Keith Barton, Ahmed Elkarmouty, Eleni Nikita, Giacinto Triolo, Soledad Aguilar-Munoa, Saurabh Goyal, Sheng Lim, Velota Sung, Imran Masood, Nicholas Wride, Amanjeet Sandhu, Elizabeth Hill, John Sparrow, Fiona Grey, Rupert Bourne, Gnanapragasam Nithyanandarajah, Catherine Willshire, Philip Bloom, Faisal Ahmed, Franesca Cordeiro, Laura Crawley, Eduardo Normando, Sally Ameen, Joanna Tryfinopoulou, Alistair Porteous, Gurjeet Jutley, Dimitrios Bessinis, James Kirwan, Shahiba Begum, Anastasios Sepetis, Edward Rule, Richard Thornton, Andrew McNaught, Nitin Anand, Anil Negi, Obaid Kousha, Marta Hovan, Roshini Sanders, Pankaj Kumar Agarwal, Andrew Tatham, Leon Au, Cecelia Fenerty, Tanya Karaconji, Brett Drury, Duya Penmol, Ejaz Ansari, Albina Dardzhikova, Reza Moosavi, Richard Imonikhe, Prodromos Kontovourikis, Luke Membrey, Goncalo Almeida, James Tildsley, Augusto Azuara-Blanco, Angela Knox, Simon Rankin, Sara Wilson, Avinash Prabhu, Subhanjan Mukherji, Amit Datta, Alisdair Fern, Joanna Liput, Tim Manners, Josh Pilling, Clare Stemp, Karen Martin, Tracey Nixon, Caroline Cobb, Alan Rotchford, Sikander Sidiki, Atul Bansal, Graham Auger, Mary Freeman, Gordon Fernie, Alison MacDonald, Ashleigh Kernohan, Jennifer Burr, Tara Homer, Hosein Shabaninejad, Luke Vale, John Norrie.

    • Contributors AJK: guarantor, study design, data collection, manuscript writing and review, JH: study design, data analysis, manuscript writing and review. AA-B: study design, data collection, manuscript review, GM: study design, data analysis, manuscript review. JFK: study design, data collection, manuscript review. SG: study design, data collection, manuscript review. KSL: study design, data collection, manuscript review.

    • Funding The project was funded by the NIHR Health Technology Assessment Programme (Project Number 12/35/38). The Health Services Research Unit are funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorates.

    • Disclaimer The funders had no role in considering the study design or in the collection, analysis, interpretation of data, writing the report, or decision to submit the article for publication.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.