To characterize the association between illness perception factors and educational needs among neuro-ophthalmology patients at a tertiary-care academic center, using the validated Brief-Illness-Perception-Questionnaire (Brief-IPQ) and a validated psychographic segmentation tool.

Personalized information-delivery based on patient educational needs is a strategy to strengthen medical compliance. One way to optimize education in neuro-ophthalmology is to stratify patients according to educational needs using psychographic segmentation, a marketing technique that divides consumers by cognitive-behavioural subtypes. Understanding underlying illness perception factors that are associated with patient educational needs is necessary to inform development of effective educational interventions.

Adults with scheduled outpatient appointments completed the 7-question Better Conversations^© survey (Novartis Pharmaceutical Corporation), and were classified accordingly into high vs. low educational needs (HEN/LEN) categories.  Subjects also completed the 8-question Brief-IPQ, from which threatening illness degree (TID), an indicator of overall illness perception (mild/moderate/severe), and eight IPQ dimensions (illness-consequence/timeline/personal-control/treatment-control/identity/concern/coherence/emotional-impact) were calculated. Associations between educational needs and IPQ components were analyzed using chi-square. Age, gender, distance travelled, number of medications (as a proxy for health) and new vs. follow-up appointment status were considered as covariates.

Among 80 respondents (response rate 95%(80/84), ages 19-91, 65% female, 35 HEN, 45 LEN), ‘severe’ TID-scores were more prevalent in HEN compared to LEN subjects (43% vs. 20%, p=0.04, chi-square). HEN subjects also had higher emotional-impact scores (80% vs. 42%, p=0.0007, chi-square). HEN and LEN subjects did not differ with respect to other IPQ dimensions, age, gender, distance travelled, number of medications or appointment status.

The combination of severe threatening illness degree and high emotional impact in HEN neuro-ophthalmology patients suggests an underlying psycho-emotional element of illness perception that should be considered when designing effective interventions to optimize education delivery and improve compliance.