Age-Related Macular Degeneration, Cataract, Diabetic Retinopathy, Glaucoma, Vision Impairment and Blindness
Conditions
Brief summary
In this cohort study, the investigators will test vision screenings in Danish general practice for patients over 70 years of age with minimum one chronic condition. The main outcome is detection of vision impairment and secondary outcome is detection of conditions needing ophthalmologic follow-up but not presenting vision impairment at present time.
Detailed description
Introduction: The number of people living with visual impairment is increasing. Visual impairment causes loss in quality of life and reduce self-care abilities. The burden of disease is heavy for people experiencing visual impairment and their relatives. The severity and progression of age-related eye diseases are dependent on the time of detection and treatment options, making timely access to healthcare critical in reducing visual impairment. General practice plays a key role in public health by managing preventive healthcare, diagnostics and treatment of chronic conditions. General practitioners (GPs) coordinate services from other healthcare professionals. More involvement of the primary sector could potentially be valuable in detecting visual impairment. Methods: Investigators apply the Medical Research Council framework for complex interventions to develop a primary care intervention with the GP as a key actor, aimed at identifying and coordinating care for patients with low vision. The development process will engage patients, relatives and relevant health professional stakeholders. The investigators will pilot test the feasibility of the intervention in a real-world general practice setting. The intervention model will be developed through a participatory approach using qualitative and creative methods such as graphical facilitation. The project aims to explore the potentials and limitations of general practice in relation to detection of preventable vision loss. Ethics and dissemination: Ethics approval is obtained from local authority and the study meets the requirements from the Declaration of Helsinki. Dissemination is undertaken through research papers and to the broader public through podcasts and patient organisations.
Interventions
OTHERfocus on vision impairment in older patients in general practice
GP or GP nurse carry out the three vision tests. All patients visit optician shop collaborating with the project. An ophthalmologist review data from optometrists and provide an epicrisis to general practice. In case of acute conditions, the ophthalmologist is responsible for expedient treatment. If the patient needs further control by ophthalmologist within 12 month waiting time, general practice are responsible for referring the patient.
Sponsors
University of Copenhagen
Study design
Allocation
NA
Intervention model
SEQUENTIAL
Primary purpose
SCREENING
Masking
NONE
Masking description
GP's or GP nurses, optometrists and the project ophtalmologist all give their anamnesis (and potential diagnosis). Their anamnesis are blinded to each other
Eligibility
Sex/Gender
ALL
Age
70 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* +70 years * One or more chronic diseases * Are followed by GP du to chronic disease
Exclusion criteria
* Dementia diagnosis * Known eye-diseases or are currently followed by private ophtalmologist * Not able to understand Danish
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Recruitment feasibility | From invitation to participate to enrollment within 4 weeks | Total number of patients invited to participate in the study based on the exclusion sheet and the proportion of eligible patients included by GP staff |
| Adherence | From enrollment to completion of GP intervention within 3 weeks. | Proportion of patients who complete the intervention elements in general practice. |
| Acceptability | From enrollment to interview within 12 months. | Patient and health providers experiences and acceptability of the DETECT intervention |
Countries
Denmark
Contacts
CONTACTCatharina Thiel Sandholdt, phd
CONTACTFrans Boch Waldorff, prof
PRINCIPAL_INVESTIGATORFrans B Waldorff
Center for Almen Medicin, KU
Outcome results
None listed