Developing and Testing a Model to Identify Preventive Vision Loss Among Older Patients in General Practice (DETECT)

University of Copenhagen

Status: Enrolling

Conditions: Vision Impairment and Blindness; Age-Related Macular Degeneration; Cataract; Glaucoma; Diabetic Retinopathy

Treatments: Other: focus on vision impairment in older patients in general practice

Study type: Interventional

Funder types: Other

Identifiers

NCT07015034

869353 (Other Grant/Funding Number)

Details and patient eligibility

About

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.

Full 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.

Enrollment: 460 estimated patients

Sex: All

Ages: 70+ years old

Volunteers: Accepts Healthy Volunteers

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

Trial design

Primary purpose: Screening

Allocation: N/A

Interventional model: Sequential Assignment

Masking: None (Open label)

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460 participants in 1 patient group

Three vision tests in general practice

Other group

Description:

All patients recruited in general practice are asked to fill out a patient questionnaire and examined: - Collenbrander Mixed contrast card: testing near vision binocularly at 40 cm, using both 100% and 10% contrast. - Amsler Test: Conducted for both eyes to check for central vision issues. - Visual Field Test: Performed using the Donders method to assess peripheral vision, conducted for both eyes. After tests in general practice, all patients undergo a comprehensive vision assessment at local optician shops, which include the following tests: * Habitual Vision Testing: Near and distance vision with habitual glasses. * Best Corrected Distance Vision: Monocular and binocular. * Intraocular Pressure Measurement Assessed using air tonometry or Icare. * Ocular Imaging: 3D peripapillary and macula optical coherence tomography (OCT) scans, and fundus photography. A project ophtalmologist analyze patient-data from optometrists.

Treatment:

Other: focus on vision impairment in older patients in general practice