International Centre for Eye Health, Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
Kitale County referral and teaching Hospital, Ravine Road, P.O. Box 98, Kitale, 30200, Kenya.
Trials. 2019 Aug 14;20(1):502. doi: 10.1186/s13063-019-3615-x.
Globally, eye care provision is currently insufficient to meet the requirement for eye care services. Lack of access and awareness are key barriers to specialist services; in addition, specialist services are over-utilised by people with conditions that could be managed in the community or primary care. In combination, these lead to a large unmet need for eye health provision. We have developed a validated smartphone-based screening algorithm (Peek Community Screening App). The application (App) is part of the Peek Community Eye Health system (Peek CEH) that enables Community Volunteers (CV) to make referral decisions about patients with eye problems. It generates referrals, automated short messages service (SMS) notifications to patients or guardians and has a program dashboard for visualising service delivery. We hypothesise that a greater proportion of people with eye problems will be identified using the Peek CEH system and that there will be increased uptake of referrals, compared to those identified and referred using the current community screening approaches.
A single masked, cluster randomised controlled trial design will be used. The unit of randomisation will be the 'community unit', defined as a dispensary or health centre with its catchment population. The community units will be allocated to receive either the intervention (Peek CEH system) or the current care (periodic health centre-based outreach clinics with onward referral for further treatment). In both arms, a triage clinic will be held at the link health facility four weeks from sensitisation, where attendance will be ascertained. During triage, participants will be assessed and treated and, if necessary, referred onwards to Kitale Eye Unit.
We aim to evaluate a M-health system (Peek CEH) geared towards reducing avoidable blindness through early identification and improved adherence to referral for those with eye problems and reducing demand at secondary care for conditions that can be managed effectively at primary care level.
The Pan African Clinical Trials Registry (PACTR), 201807329096632 . Registered on 8 June 2018.
在全球范围内，眼科保健服务的提供目前还不足以满足眼科保健服务的需求。获得服务的机会有限和缺乏认识是获得专科服务的主要障碍；此外，专科服务被那些可以在社区或初级保健中得到治疗的人过度利用。这两者结合导致了大量未满足的眼科保健需求。我们开发了一种经过验证的基于智能手机的筛查算法（Peek 社区筛查应用程序）。该应用程序（应用程序）是 Peek 社区眼健康系统（Peek CEH）的一部分，使社区志愿者（CV）能够对有眼部问题的患者做出转诊决定。它生成转诊、自动短信服务（SMS）通知患者或监护人，并具有可视化服务交付的计划仪表板。我们假设，与使用当前社区筛查方法相比，使用 Peek CEH 系统可以识别出更多有眼部问题的人，并且转诊率会增加。
将使用单盲、集群随机对照试验设计。随机分组的单位将是“社区单位”，定义为带有其服务人群的药房或保健中心。社区单位将被分配接受干预措施（Peek CEH 系统）或当前护理（定期以保健中心为基础的外展诊所，并进行进一步治疗的转诊）。在这两个臂中，将在动员后的四周在联系卫生机构举行分诊诊所，以确定就诊情况。在分诊时，将对参与者进行评估和治疗，如果需要，将转诊到基特莱眼科中心。
我们旨在评估一种 M-健康系统（Peek CEH），通过早期发现和提高对有眼部问题患者的转诊率，以及减少可在初级保健层面有效治疗的二级保健需求，来减少可避免的失明。
泛非临床试验注册处（PACTR），201807329096632。于 2018 年 6 月 8 日注册。
