Dataset Information

Abandonment of low-vision devices in an outpatient population.

ABSTRACT: To investigate abandonment rate of prescribed low-vision devices for near tasks and factors associated with abandonment in a U.S. outpatient population.A telephone survey was administered to 88 patients with low vision from four clinical sites about 1 year after examination and prescription of devices. Patients were surveyed on timing and frequency of use and reasons for abandonment of devices. The main outcome measure (abandonment) was defined as patient report of no use of prescribed device in the previous 3 months. Multivariate logistic regression was used to investigate significant vision and demographic factors related to abandonment.Of 119 prescribed devices, 19% (95% CI, 12 to 26) had not been used within the previous 3 months. Mean (±SD) better eye visual acuity at examination was 0.61 ± 0.29 logMAR, and mean age was 77 ± 17 years. Mean time between device prescription and survey was 11 ± 3 months. Device abandonment was not associated with age (p = 0.863), time since prescription (p = 0.125), visual acuity (p = 0.804), or category of magnification device (spectacle, handheld, stand, or video) (p = 0.412). There was a significant association between documented non-central visual field loss and abandonment of magnification device (p = 0.046). Repeat administration of the survey resulted in the same abandonment classification in 15 of 15 patients (100%).Abandonment rate was similar for this outpatient population to those previously reported in the U.S. veteran inpatient population and in other countries. Patients with visual field loss may be more likely to abandon prescribed devices.

SUBMITTER: Dougherty BE

PROVIDER: S-EPMC3204005 | biostudies-literature | 2011 Nov

REPOSITORIES: biostudies-literature

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Abandonment of low-vision devices in an outpatient population.

Dougherty Bradley E BE Kehler K Bradley KB Jamara Richard R Patterson Nicole N Valenti Denise D Vera-Diaz Fuensanta A FA

Optometry and vision science : official publication of the American Academy of Optometry 20111101 11

<h4>Purpose</h4>To investigate abandonment rate of prescribed low-vision devices for near tasks and factors associated with abandonment in a U.S. outpatient population.<h4>Methods</h4>A telephone survey was administered to 88 patients with low vision from four clinical sites about 1 year after examination and prescription of devices. Patients were surveyed on timing and frequency of use and reasons for abandonment of devices. The main outcome measure (abandonment) was defined as patient report o ...[more]

PMID: 21822160

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Project description:ImportanceMost patients with low vision are elderly and have functional limitations from other health problems that could add to the functional limitations caused by their visual impairments.ObjectiveTo identify factors that contribute to visual ability measures in patients who present for outpatient low vision rehabilitation (LVR) services.Design, setting, and participantsAs part of a prospective, observational study of new patients seeking outpatient LVR, 779 patients from 28 clinical centers in the United States were enrolled in the Low Vision Rehabilitation Outcomes Study (LVROS) from April 25, 2008, through May 2, 2011. The Activity Inventory (AI), an adaptive visual function questionnaire, was administered to measure overall visual ability and visual ability in 4 functional domains (reading, mobility, visual motor function, and visual information processing) at baseline before LVR. The Geriatric Depression Scale, Telephone Interview for Cognitive Status, and Medical Outcomes Study 36-Item Short-Form Health Survey physical functioning questionnaires were also administered to measure patients' psychological, cognitive, and physical health states, respectively.Main outcomes and measuresPredictors of visual ability and functional domains as measured by the AI.ResultsAmong the 779 patients in the LVROS sample, the mean age was 76.4 years, 33% were male, and the median logMAR visual acuity score was 0.60 (0.40-0.90 interquartile range). Correlations were observed between logMAR visual acuity and baseline visual ability overall (r = -0.42) and for all functional domains. Visual acuity was the strongest predictor of visual ability (P < .001) and reading ability (P < .001) and had a significant independent effect on the other functional domains. Physical ability was independently associated with (P < .001) overall visual ability as well as mobility and visual motor function. Depression had a consistent independent effect (P < .001) on overall visual ability and on all functional domains, whereas cognition had an effect on only reading and mobility (P < .001).Conclusions and relevanceVisual ability is a multidimensional construct, with visual acuity, depression, physical ability, and cognition explaining more than one-third of the variance in visual ability as measured by the AI. The significant contributions of the nonvisual factors to visual ability measures and the rehabilitation potential (ie, ceiling) effects they may impose on LVR are important considerations when measuring baseline visual ability and ultimately LVR outcomes in ongoing clinical research.

Project description:PurposeTo characterize functional complaints of new low-vision rehabilitation patients.DesignProspective observational study.ParticipantsThe Low Vision Rehabilitation Outcomes Study recruited 819 patients between 2008 and 2011 from 28 clinical centers in the United States.MethodsNew patients referred for low-vision rehabilitation were asked, "What are your chief complaints about your vision?" before their appointment. Full patient statements were transcribed as free text. Two methods assessed whether statements indicated difficulty in each of 13 functional categories: (1) assessment by 2 masked clinicians reading the statement, and (2) a computerized search of the text for specific words or word fragments. Logistic regression models were used to predict the influence of age, gender, and visual acuity on the likelihood of reporting a complaint in each functional category.Main outcome measuresPrevalence and risk factors for patient concerns within various functional categories.ResultsReading was the most common functional complaint (66.4% of patients). Other functional difficulties expressed by at least 10% of patients included driving (27.8%), using visual assistive equipment (17.5%), mobility (16.3%), performing in-home activities (15.1%), lighting and glare (11.7%), and facial recognition and social interactions (10.3%). Good agreement was noted between the masked clinician graders and the computerized algorithm for categorization of functional complaints (median κ of 0.84 across the 13 categories). Multivariate logistic regression models demonstrated that the likelihood of reading difficulties increased mildly with age (odds ratio, 1.4 per 10-year increment in age; 95% confidence interval, 1.3-1.6), but did not differ with visual acuity (P = 0.09). Additionally, men were more likely to report driving difficulties and difficulties related to lighting, whereas women were more likely to report difficulty with either in-home activities or facial recognition or social interaction (P<0.05 for all). Mobility concerns, defined as walking difficulty and out-of-home activities, showed no relationship to gender, age, or visual acuity.ConclusionsReading was the most commonly reported difficulty, regardless of the patient's diagnosis. Neither visual acuity nor gender were predictive of reading concerns, although, age showed a small effect. Addressing reading rehabilitation should be a cornerstone of low-vision therapy.

Project description:SignificanceThis pilot study provides some insight about the potential benefits of telerehabilitation training to improve the reading ability of adults with low vision using magnifiers, to spur future work with larger groups. Telerehabilitation services can be implemented clinically to facilitate access to follow-up care for low vision.PurposeA recent Cochrane systematic review revealed that there are no published visual function outcomes for telerehabilitation with handheld magnification devices for low vision; thus, this study aimed to provide evidence for its preliminary efficacy.MethodsOne to 4 months after receiving a new magnification device (i.e., handheld or stand optical magnifier or portable electronic magnifier), 14 adult low vision patients (with any visual acuity level or ocular diagnosis) received two training sessions at home via telerehabilitation with their vision rehabilitation provider located remotely in-office. Telerehabilitation included a loaner smartphone for Zoom videoconferencing with remote control access software. The Minnesota Low-Vision Reading Test was administered during each of the telerehabilitation sessions to assess near reading (acuity and speed) with the new magnifier.ResultsMean reading acuity with the magnifier was 0.17 logMAR across subjects before training at telerehabilitation session 1, which significantly improved to 0.09 on average a few weeks later at telerehabilitation session 2 (95%confidence interval, -0.001 to -0.16; P = .047). Logarithm reading speed with the magnifier for the reading acuity level at session 1 improved significantly by 0.18 log words per minute on average for the same text size at session 2 (95% confidence interval, 0.06 to 0.29; P = .002). With the magnifier at session 2, 71% of participants gained at least 0.1 log unit in reading acuity, and half improved by >0.01 in log reading speed; all participants with increased reading speed also improved in reading acuity ( P = .02).ConclusionsThese preliminary data support that telerehabilitation can enhance reading ability and efficiency with newly prescribed magnifiers as an alternative option to in-office vision rehabilitation.

Project description:BackgroundLow vision affects over 300 million people worldwide and can compromise both activities of daily living and quality of life. Rehabilitative training and vision assistive equipment (VAE) may help, but some visually impaired people have limited resources to attend in-person visits at rehabilitation clinics to receive training to learn to use VAE. These people may be able to overcome barriers to care through remote, Internet-based consultation (i.e. telerehabilitation).ObjectivesTo compare the effects of telerehabilitation with face-to-face (e.g. in-office or inpatient) vision rehabilitation services for improving vision-related quality of life and near reading ability in people with visual function loss due to any ocular condition. Secondary objectives were to evaluate compliance with scheduled rehabilitation sessions, abandonment rates for VAE devices, and patient satisfaction ratings.Search methodsWe searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2019, Issue 6); Ovid MEDLINE; Embase.com; PubMed; ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). We did not use any language restriction or study design filter in the electronic searches; however, we restricted the searches from 1980 onwards because the Internet was not introduced to the public until 1982. We last searched the electronic databases on 24 June 2019.Selection criteriaWe planned to include randomized controlled trials (RCTs) or controlled clinical trials (CCTs) in which participants diagnosed with low vision were undergoing low vision rehabilitation using an Internet, web-based technology compared with an approach involving in-person consultations.Data collection and analysisTwo review authors independently screened titles and abstracts and then full-text articles against the eligibility criteria. We planned to have two review authors independently abstract data from the included studies. Any discrepancies were resolved by discussion.Main resultsWe identified two ongoing studies, but did not find any completed RCTs and CCTs that met the inclusion criteria for this review. We did not conduct a quantitative analysis. We discussed review articles on telemedicine for facilitating communication with elderly individuals or for providing remote ophthalmological care.Authors' conclusionsWe did not find any evidence from RCTs or CCTs on the efficacy of using telerehabilitation for remote delivery of rehabilitation services to individuals with low vision. Given the disease burden and the growing interest in telemedicine, the two ongoing studies, when completed, may provide evidence in understanding the potential for telerehabilitation as a platform for providing services to people with low vision.

Dataset Information

Abandonment of low-vision devices in an outpatient population.

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Abandonment of low-vision devices in an outpatient population.

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