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Jennifer H. Acton, Bablin Molik, Helen Court, Tom H. Margrain; Effect of a Home Visit–Based Low Vision Rehabilitation Intervention on Visual Function Outcomes: An Exploratory Randomized Controlled Trial. Invest. Ophthalmol. Vis. Sci. 2016;57(15):6662-6667. doi: 10.1167/iovs.16-19901.
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To examine the effect of a home visit–based visual rehabilitation intervention on: (1) self-reported visual function and (2) depression, wellbeing, loneliness, adjustment to visual loss, and generic health-related quality of life.
In an exploratory, assessor-masked, individually randomized, single-center controlled trial, 67 participants (age: 75.22 ± 16.21 years) with low vision were allocated either to receive the home visit–based visual rehabilitation intervention (n = 35) or to a waiting list control arm (n = 32). Outcome measures were collected by telephone interview at baseline and 6 months later. The primary outcome measure was the 48-item Veterans Affairs Low Vision Visual Functioning Questionnaire (VA LV VFQ-48). Secondary outcome measures were: the Patient Health Questionnaire; the Warwick-Edinburgh Mental Well-being Scale, the Adjustment to Age-related Visual Loss Scale, the standardized health-related quality of life questionnaire, and the University of California, Los Angeles Loneliness Scale. Questionnaire scores at follow-up were analyzed using analysis of covariance, controlling for the baseline score and the variables, age, number of comorbidities, visual acuity, and baseline wellbeing score.
Visual function (VA LV VFQ-48) improved at follow-up in both groups, with a significantly greater improvement demonstrated by the intervention group (95% confidence interval, 0.33–0.68 logits, P = 0.031), with a moderate effect size (0.55). Secondary outcomes did not indicate any statistically significant differences between groups.
The study provides preliminary evidence that a home visit–based visual rehabilitation intervention has a positive influence on vision-related functional outcomes. A larger trial with an expanded intervention to include a mental health component and cost-effectiveness analysis is needed. (ISRCTN.com number, 44807874.)
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