Department of Ophthalmology, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.
Quality of Care, Aging and Later Life, Health Behaviors and Chronic Diseases, Amsterdam Public Health, Amsterdam, The Netherlands.
Trials. 2024 Feb 2;25(1):102. doi: 10.1186/s13063-023-07882-0.
Among older people undiagnosed and untreated vision impairment and blindness are common. The leading causes are uncorrected refractive errors and cataracts. Vision problems are associated with a lower quality of life, several health problems, and a higher chance of falling accidents and fractures. To eliminate avoidable vision impairment and blindness, targeted eye screening programs are recommended. Older patients, receiving home healthcare, have not yet been considered as a population at risk who could benefit from eye screening.
A cluster-randomized controlled trial will be conducted to investigate the cost-effectiveness and cost-utility of online nurse-assisted eye screening in home healthcare, compared to care as usual, in reducing avoidable vision impairment. A healthcare and societal perspective will be used. The study will be performed in collaboration with several home healthcare organizations in the Netherlands. The online eye screening consists of near and distance visual acuity, followed by an Amsler grading test. Measurements in both groups will take place at baseline and after 6 and 12 months of follow-up. A total of 240 participants will be recruited. Older men and women (65 +), who receive home-based nursing and are cognitively able to participate, will be included. The primary outcome will be the change of two lines or more on the Colenbrander-1 M visual acuity chart between baseline and 12-month follow-up.
An eye screening for populations at risk contributes to the detection of undiagnosed and untreated vision impairment. This may reduce the health-related consequences of vision loss and the high economic burden associated with vision impairment.
ClinicalTrials.gov NCT06058637. Registered on 27 September 2023.
在老年人中，未诊断和未经治疗的视力障碍和失明很常见。主要原因是未矫正的屈光不正和白内障。视力问题与生活质量下降、多种健康问题以及跌倒事故和骨折的风险增加有关。为了消除可避免的视力障碍和失明，建议开展有针对性的眼部筛查计划。接受家庭保健的老年患者尚未被视为可能受益于眼部筛查的高危人群。
将开展一项集群随机对照试验，以评估在线护士辅助家庭保健中的眼部筛查在减少可避免的视力障碍方面的成本效益和成本效用，与常规护理相比。将采用医疗保健和社会视角。该研究将与荷兰的几家家庭保健组织合作进行。在线眼部筛查包括近视力和远视力，随后进行 Amsler 分级测试。两组的测量均在基线时以及 6 个月和 12 个月的随访时进行。将招募 240 名参与者。将纳入接受家庭基础护理且认知能力足以参与的 65 岁及以上的老年男性和女性。主要结局指标是基线和 12 个月随访之间 Colenbrander-1M 视力表上两条或更多线的变化。
对高危人群进行眼部筛查有助于发现未诊断和未经治疗的视力障碍。这可能会降低与视力丧失相关的健康后果和与视力障碍相关的高经济负担。
ClinicalTrials.gov NCT06058637. 注册于 2023 年 9 月 27 日。
