加齢黄斑変性，糖尿病および緑内障患者の受診率と手帳持参率の比較

Submission of data notebooks as related to rate of follow-up visit in patients with glaucoma, diabetes mellitus or age-related macular degeneration

要約　目的：加齢黄斑変性患者，緑内障患者および糖尿病網膜症患者の病識を調べるために，受診率と手帳の持参率を比較検討した。

対象と方法：対象は，次回診察を予約した加齢黄斑変性患者170名（75.8±9.5歳，男性114名，女性56名），糖尿病患者377名（66.4±12.0歳，男性204名，女性173名）および緑内障患者513名（72.1±11.7歳，男性223名，女性290名）である。初診時に手帳を渡し，3年間にわたり受診率と持参率を調査した。

結果：加齢黄斑変性患者160名（94.1％），糖尿病患者304名（80.6％），緑内障患者396名（77.2％）が調査を完了した。全期間における持参率は，加齢黄斑変性患者が91.0％（3,700回中3,367回），糖尿病患者が89.3％（3,913回中3,495回），緑内障患者が92.7％（7,528回中6,981回）であり，有意差はなかった。いずれの疾患でも持参率は1年までは有意に上昇し（p＜0.0001），その後は変化がなかった。50〜79歳では，加齢黄斑変性および緑内障患者は糖尿病患者に比較して持参率は有意に高く（p＜0.002），加齢黄斑変性患者と緑内障患者では80歳以上の患者は50〜79歳の患者に比べて低率であった（p＜0.0001）。いずれの疾患でも，脱落患者の手帳の持参率は調査完了患者に比較して有意に低率であった（p＜0.01）。

結論：いずれの疾患でも，高齢化するに従い持参率は低下しており，脱落患者の手帳の持参率は調査完了患者に比較して有意に低率であった。同年齢層では，加齢黄斑変性および緑内障患者は糖尿病患者に比較して持参率は有意に高かった。

Abstract　Purpose：To present a report on the current state of submission of data notebooks as related to rate of follow-up visit in patients with glaucoma, diabetes mellitus or age-related macular degeneration（AMD）.

Cases and Method：This study was made on 860 outpatients visiting our department. The series comprised 396 cases with glaucoma, 304 with diabetes mellitus, and 160 with AMD. Their age averaged 72.11±11.7 years, 66.4±12.0 years, and 75.8±9.5 years respectively. Patients were given data notebooks and the status of bringing the notebooks was evaluated for 3 years.

Results：Data notebook was carried by 92.7％ of patients with glaucoma, 89.3％ with diabetes mellitus, and 91.0％ with AMD. Rate of submission of notebooks increased significantly until one year after handing-over of notebooks（p＜0.0001）. Among patients aged from 50 to 79 years, rates of submission of notebooks were significantly higher in patients with glaucoma or AMD than diabetes mellitus（p＜0.002）. In patients with glaucoma or AMD aged 80 years or over, rate of submission was significantly lower than those aged from 50 to 79 years（p＜0.0001）. It was also lower in patients who dropped out than those who completed the study.

Conclusion：Rate of submission of notebooks decreased along with age. It was lower in drop-outs than in those who completed the study. It was higher in patients with glaucoma or AMD than in those with diabetes mellitus.