Trust in the Provider and Glaucoma-Related Blindness

Purpose. We hypothesized that lower trust in the physician is associated with worse visual outcomes in glaucoma. Methods. Subjects completed the Trust in Provider Scale (TPS) and performed visual field tests at least two years apart. The primary outcome was glaucoma-related blindness. Results. Subjects with glaucoma-related blindness scored lower on the TPS (74.9 ± 7.4, n = 21) than subjects without blindness (78.8 ± 6.9, n = 39; P = 0.04). In white subjects, TPS scores were similar for blind (77.1 ± 7.7, n = 12) versus not blind subjects (76.4 ± 6.7, n = 10; P = 0.82). For nonwhite subjects, TPS scores were lower for blind (72.0 + 6.2, n = 9) versus not blind subjects (79.6 ± 6.9, n = 29; P = 0.005). In multiple regression models, the interaction between race and trust was significant (P = 0.007), indicating that the increase in odds for blindness with each unit decrease in TPS score was different for white versus nonwhite subjects. Discussion. Glaucoma patients' trust in the physician is associated with glaucoma-related blindness in this study. The association between lower trust in the physician with blindness in patients of nonwhite race deserves further attention as we strive to reduce disparities in visual outcomes.