Centre for Global Health, Department of Public Health, Aarhus University , Aarhus, Denmark.
Ophthalmic Research Centre, Shahid Beheshti University of Medical Sciences , Tehran, Iran.
Ophthalmic Epidemiol. 2020 Dec;27(6):417-428. doi: 10.1080/09286586.2020.1768552. Epub 2020 May 24.
To evaluate the effect of a mobile-based screening programme on eye care utilization in Iran.
In this cluster randomized community trial, a representative sample of residents aged≥50 years from urban and rural areas in four districts in Tehran province were enrolled. The clusters were randomly assigned to one of the three parallel arms; the mHealth arm with digital data collection, vision screening test and retina evaluation using an integrated mobile application, the conventional arm with manual data collection and screening tests using Snellen chart and Fundus photography at the local primary healthcare facility, and the control arm with manual data collection without screening tests. The main outcome measure was eye care utilization which was defined as at least one visit to an optometrist or ophthalmologist.
Of 3312 eligible individuals, 2520 (76.1%) participated. In the first 3 months after the screening programme, eye care utilization was higher among those who were referred by the mHealth method (35.6% 95%CI: 31.1-40.4%) compared to those referred by the conventional method (32.7%, 95%CI: 27.5-38.2%) and to those observed in the control arm (4.5%, 95%CI: 3.2-6.0). Eye care utilization improved (OR = 1.5, 95%CI: 1.2-1.9) among the referred people after the screening programme compared to the utilization before this programme; however, this improvement was significantly higher in the mHealth method (OR: 1.7, 95%CI: 1.2-2.4) compared to the conventional method (OR: 1.2, 95%CI: 0.8-1.8).
The mobile-based screening programme can significantly improve eye care utilization at the community level.
评估基于移动设备的筛查计划对伊朗眼部保健利用的影响。
在这项基于群组的随机社区试验中，从德黑兰省四个区的城市和农村地区招募了年龄≥50 岁的代表性居民样本。将群组随机分配到三个平行组中的一个；移动医疗组使用数字数据收集、视力筛查测试和使用集成移动应用程序进行视网膜评估，常规组使用 Snellen 图表和眼底照相在当地初级保健设施进行手动数据收集和筛查测试，对照组使用手动数据收集而不进行筛查测试。主要结局指标是眼部保健利用，定义为至少一次去验光师或眼科医生就诊。
在 3312 名合格的个体中，有 2520 名（76.1%）参与了研究。在筛查计划后的头 3 个月，通过移动医疗方法转诊的人群中眼部保健利用率较高（35.6%，95%CI：31.1-40.4%），高于通过常规方法转诊的人群（32.7%，95%CI：27.5-38.2%）和对照组（4.5%，95%CI：3.2-6.0%）。与该计划之前相比，在筛查计划后转诊人群的眼部保健利用率提高（OR=1.5，95%CI：1.2-1.9）；然而，与常规方法相比（OR：1.2，95%CI：0.8-1.8），移动医疗方法的这种改善显著更高（OR：1.7，95%CI：1.2-2.4）。
基于移动设备的筛查计划可以显著提高社区层面的眼部保健利用率。
