Effectiveness of an innovative and comprehensive eye care model for individuals in residential care facilities: results of the residential ocular care (ROC) multicentred randomised controlled trial. Issue 11 (19th February 2020)

• Record Type: Journal Article
• Authors: Man, Ryan Eyn Kidd; Gan, Alfred Tau Liang; Constantinou, Marios; Fenwick, Eva K; Holloway, Edith; Finkelstein, Eric A; Coote, Michael; Jackson, Jonathan; Rees, Gwyn; Lamoureux, Ecosse Luc
• Is Part Of: British journal of ophthalmology. Volume 104:Issue 11(2020)
• Page Start: 1585
• Page End: 1590
• Publication Date: 2020-02-19
• Subjects: vision -- clinical trial -- treatment surgery; Ophthalmology -- Periodicals; 617.7
• DOI: 10.1136/bjophthalmol-2019-315620
• Languages: English
• ISSNs: 0007-1161

Abstract

Abstract : Background: To assess the clinical and patient-centred effectiveness of a novel residential ocular care (ROC) model in Australian individuals residing in residential care. Methods: In this prospective, multicentred, randomised controlled trial conducted in 38 Australian aged-care facilities (2015–2017), 178 visually impaired individuals living in residential care facilities (mean age ±SD: 83.9±8.6 years; 65.7% women) were cluster randomised to ROC (n=95) or usual care (n=83) pathways. The ROC arm comprised a tailored and comprehensive within-site eye examination and care rehabilitation pathway, while usual care participants were given a referral to an external eyecare provider. Outcomes included presenting distance and near visual acuity (PNVA); Rasch-transformed Reading, Emotional and Mobility scores from the Impact of Vision Impairment questionnaire; quality of vision (QoV comprising Rasch-transformed Frequency, Severity and Bother domains) scores; Euroqol-5-Dimensions (raw scores); Cornell Scale for Depression (raw scores) and 6-month falls frequency, assessed at baseline and 6 months post intervention. Within-group and between-group comparisons were conducted using linear mixed models, adjusted for baseline differences in characteristics between the two arms. Results: At 6 months, intention-to-treat analyses showed significant between-group improvements in ROC residents compared with usual care for PNVA, Emotional and QoV scores (all p<0.05) These significant findings were retained in per-protocol analyses. No other between-group changes were observed. Conclusion: Our ROC model was effective in improving near vision, emotional well-being and perceived burden of vision-related symptoms in residential care dwellers in Australia with vision impairment. Future studies to evaluate the cost effectiveness and implementation of ROC in Australia are warranted.