Effectiveness of the community-based Low Vision Service Wales: a long-term outcome study

Br J Ophthalmol. 2013 Apr;97(4):487-91. doi: 10.1136/bjophthalmol-2012-302416. Epub 2013 Feb 14.

Abstract

Aims: To evaluate the long-term effectiveness of the community-based Low Vision Service Wales (LVSW).

Methods: A long-term observational study of the Government-funded, community-based, low-vision rehabilitation service which operates in over 180 optometry practices in Wales. Participants were recruited from the LVSW (n=342; 246 women; median age 82 years) at baseline (before the Low Vision intervention). The primary outcome measure was change in visual disability as evaluated by the seven-item National Eye Institute Visual Function Questionnaire (NEI-VFQ). Change was measured on the same cohort at three separate time points, and comparisons were made between these: baseline-3 months; 3-18 months; baseline-18 months. Secondary outcome measures included: use of low-vision aids (LVAs) and satisfaction with the service provided.

Results: Questionnaires were sent to 281 participants (whose visual disability had been measured at baseline and 3 months) at 18 months postintervention. Responses were received from 190 (67.6%) people; 24 were deceased. Self-reported visual disability was significantly reduced (Wilcoxon Signed Rank (WSR) test: p<0.001) between baseline and 18 months by -0.28 logits (-1.24 to 0.52). This was less than that found between baseline and 3 months; -0.61 logits (-1.81 to 0.02). At 18 months, 79% patients used their LVAs at least once a week which was not significantly different to that found at 3 months (WSR: p=0.127).

Conclusions: This study provides evidence that the effect of the LVSW persists over a period of 18 months; disability is reduced from baseline, and use of LVAs remains high.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Community Health Services / organization & administration*
  • Delivery of Health Care / standards*
  • Disability Evaluation
  • Female
  • Humans
  • Male
  • Patient Satisfaction / statistics & numerical data
  • Primary Health Care / organization & administration*
  • Program Evaluation
  • Sensory Aids / statistics & numerical data
  • Sickness Impact Profile
  • Surveys and Questionnaires
  • Treatment Outcome
  • Vision, Low / diagnosis
  • Vision, Low / rehabilitation*
  • Visual Acuity / physiology
  • Visually Impaired Persons / rehabilitation*
  • Wales