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Walter Wittich, Donald H. Watanabe, Marie-Chantal Wanet-Defalque, Olga Overbury; From Referral To Rehabilitation: The Montreal Barriers Study - Phase 2. Invest. Ophthalmol. Vis. Sci. 2011;52(14):396.
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The Montreal Barriers Study was designed to investigate awareness regarding low vision rehabilitation among patients across four university-based ophthalmology departments in the greater Montreal area. We previously presented data on the percentage of participants that were aware and had utilized these services (53%). 14% were aware but chose not to avail themselves of these services, whereas 33% were unaware, but were informed and referred during the recruitment process. Phase 2 of the Barriers Study focused on whether this last group indeed accessed rehabilitation through local agencies, since lack of referral was not the barrier to access.
From 2007 to 2010, 170 participants identified themselves as unaware of low vision rehabilitation. Each received a referral form at the ophthalmologists’ office, which was filled out and placed inside the medical file before their appointment for signature by their physician. In June 2010, a list of participant names was given to the local rehabilitation agencies (MAB-Mackay Rehabilitation Center/MMRC & Institut Nazareth et Louis Braille/INLB) to track who had received services.
15 participants already had an active agency file prior to the Barriers study and were therefore removed from this analysis. Of the remaining sample, 87 (56%) are currently receiving low vision rehabilitation, whereas 50 (32%) never entered the rehab system, 16 (11%) made initial contact but either declined services or did not follow through, and 2 (1%) were not yet eligible but have a file due to the progressive nature of their impairment. Of the 69 referrals to the INLB, 39 dossiers had been created (57%), representing a statistically significantly lower access rate in the French-speaking community when compared to the English-speaking clientele (n =66, 77%), Χ 2 (1, n = 155) = 7.2, p < .01.
Even under ideal circumstances for referral, where eligible patients were identified by research personnel and the required forms were completed for the ophthalmology staff and faxed to the agency, only 67% found their way to a rehabilitation agency and 56% utilized the services. We speculate that lack of perceived need or independent travel difficulties contribute to this situation. In addition, cultural and/or regional differences seem to exist in access behaviour.
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