September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Self-care tools to treat depressive symptoms in patients with age-related eye disease
Author Affiliations & Notes
  • Hortence Kamga
    University of Montreal , Montreal, Quebec, Canada
    Maisonneuve-Rosemont Hospital, Montreal, Quebec, Canada
  • Jane McCusker
    McGill University, Montreal, Quebec, Canada
    Saint Mary's Hospital, Montreal, Quebec, Canada
  • Mark Yaffe
    McGill University, Montreal, Quebec, Canada
    Saint Mary's Hospital, Montreal, Quebec, Canada
  • Martin Cole
    McGill University, Montreal, Quebec, Canada
    Saint Mary's Hospital, Montreal, Quebec, Canada
  • Maida Sewitch
    McGill University, Montreal, Quebec, Canada
  • Tamara Sussman
    McGill University, Montreal, Quebec, Canada
  • Erin Strumpf
    McGill University, Montreal, Quebec, Canada
  • Sébastien Olivier
    University of Montreal , Montreal, Quebec, Canada
    Maisonneuve-Rosemont Hospital, Montreal, Quebec, Canada
  • Walter Wittich
    School of Optometry, University of Montreal, Montreal, Quebec, Canada
    Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Montreal, Quebec, Canada
  • Solmaz Moghadaszadeh
    University of Montreal , Montreal, Quebec, Canada
    Maisonneuve-Rosemont Hospital, Montreal, Quebec, Canada
  • Ellen E Freeman
    University of Montreal , Montreal, Quebec, Canada
    Maisonneuve-Rosemont Hospital, Montreal, Quebec, Canada
  • Footnotes
    Commercial Relationships   Hortence Kamga, None; Jane McCusker, None; Mark Yaffe, None; Martin Cole, None; Maida Sewitch, None; Tamara Sussman, None; Erin Strumpf, None; Sébastien Olivier, None; Walter Wittich, None; Solmaz Moghadaszadeh, None; Ellen Freeman, None
  • Footnotes
    Support  Fonds de la recherche en santé du Québec (FRSQ) : Réseau Vision
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 5588. doi:
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      Hortence Kamga, Jane McCusker, Mark Yaffe, Martin Cole, Maida Sewitch, Tamara Sussman, Erin Strumpf, Sébastien Olivier, Walter Wittich, Solmaz Moghadaszadeh, Ellen E Freeman; Self-care tools to treat depressive symptoms in patients with age-related eye disease. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5588.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Depression is a common problem in people with age-related macular degeneration (AMD) and diabetic retinopathy (DR). Antidepressants and psychotherapy are often underutilized. Self-care tools have shown efficacy in some trials although many have been done in young, volunteer populations and none in those with limited vision. Our goal was to determine if self-care tools plus limited telephone support could reduce depressive symptoms.

Methods : A single-blind randomized controlled clinical trial is being conducted at Maisonneuve-Rosemont Hospital in Montreal, Canada. All eligible patients are invited to participate in the trial. To be eligible, participants must have either AMD or DR, at least mild depression, and must have visual acuity better than 20/200. Half are randomized to the intervention arm and half to delayed intervention/usual care. The intervention consists of large print written and audio tools incorporating cognitive-behavioral principles plus 3x10-minute telephone calls from a coach. Eight-week follow-up data collection is collected by telephone. The primary outcome is the 8-week change in depressive symptoms as measured by the Patient Health Questionnaire (PHQ-9). Secondary outcomes include anxiety, life space, self-efficacy, and medication adherence.

Results : Seventy-four participants have been recruited achieving our target sample size. Eight-week follow-up data collection has been completed on 59 people (80%) with follow-up expected to finish shortly. The mean age is 74 years old (standard deviation (SD)=11), 61% are women, the mean logMAR acuity in the better eye is 0.4 (SD=0.2), while the mean PHQ-9 score is 10 (SD=4) indicating moderate depressive symptoms. In preliminary results, there are minimal differences between the two arms for all outcomes (P>0.05). Only 44% of people in the intervention group reported using the tools. Some reasons for disuse included disinterest, difficulty with vision, being too busy, and poor health.

Conclusions : Self-care tools plus telephone coaching did not reduce depressive symptoms in patients with age-related eye disease. Alternative self-care strategies need to be developed for this population.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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