June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Barriers and facilitators in the referral pathway to low vision services: a qualitative study
Author Affiliations & Notes
  • Miriam Laura Stolwijk
    Amsterdam UMC, Vrije Universiteit, Department of Ophthalmology, Amsterdam Public Health research institute, Amsterdam, Netherlands
  • Ruth M A van Nispen
    Amsterdam UMC, Vrije Universiteit, Department of Ophthalmology, Amsterdam Public Health research institute, Amsterdam, Netherlands
  • Alida J van der Ham
    Amsterdam UMC, Vrije Universiteit, Department of Ethics, Law and Medical Humanities, Amsterdam Public Health research institute, Amsterdam, Netherlands
  • Esther Veenman
    Amsterdam UMC, Vrije Universiteit, Department of Ophthalmology, Amsterdam Public Health research institute, Amsterdam, Netherlands
  • Ger H.M.B. van Rens
    Amsterdam UMC, Vrije Universiteit, Department of Ophthalmology, Amsterdam Public Health research institute, Amsterdam, Netherlands
  • Footnotes
    Commercial Relationships   Miriam Stolwijk None; Ruth van Nispen None; Alida van der Ham None; Esther Veenman None; Ger van Rens None
  • Footnotes
    Support  Visio fellowship financially supported by Stichting Novum
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 1714 – F0032. doi:
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      Miriam Laura Stolwijk, Ruth M A van Nispen, Alida J van der Ham, Esther Veenman, Ger H.M.B. van Rens; Barriers and facilitators in the referral pathway to low vision services: a qualitative study. Invest. Ophthalmol. Vis. Sci. 2022;63(7):1714 – F0032.

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

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Abstract

Purpose : Despite the benefits of low vision services (LVS), a discrepancy in the need and the uptake of these services has been reported internationally. Only a few studies examined the professional’s perspective regarding barriers and facilitators in accessing LVS. This study aims to explore these parameters from both the perspective of visually impaired people and professionals from different eye care providers in the Netherlands.

Methods : A sample of older adults with macular degeneration, diabetic retinopathy and glaucoma (n=14) and a sample of healthcare professionals including ophthalmologists, low vision optometrists and LVS professionals (n=17) participated in this study. Semi structured interviews with patients and professionals were conducted and were analyzed with framework analysis using Atlas.ti software.

Results : Both patients and professionals consider having self-advocacy, motivation, social support, acceptance of the impairment, high participation needs and experienced negative impact of the impairment to facilitate access to LVS. Having good communication skills, paying attention to patient’s LVS needs and informing them about LVS as a provider, as well as having a long patient-provider relationship were also identified as facilitators. In addition, professionals perceived communication between providers regarding LVS, the presence of low vision consultation hours in the ophthalmic practice and national service provision of LVS to facilitate referral to LVS. Barriers in accessing LVS that have been identified in both samples are being less assertive, and having low motivation, low acceptance of the impairment and lack of awareness about LVS as a patient. Besides that, lack of time and absence of communication about LVS by eye care providers to patients were mentioned as barriers. According to professionals, low participation needs of patients, short disease duration, short patient-provider relationship and unavailable care coordination hinder referral to LVS as well.

Conclusions : Findings imply that provider’s lack of information provision about LVS, especially to patients who are less assertive, hamper referral to LVS. Providers should have attention for patient’s LVS needs and actively inform them and their social network about LVS to facilitate access to LVS. Educating and training providers about how and when to address LVS may help to reduce barriers in the referral pathway to LVS.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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