Abstract
Purpose :
Digital exclusion is a growing challenge facing teleophthalmology and a potential barrier to widespread implementation of smartphone hyperacuity testing. This study seeks to examine the association of digital exclusion and social deprivation with programme adherence and clinical outcomes among participants in a smartphone home monitoring programme using the Alleye app for retinal disease.
Methods :
Retrospective analysis of 89 patients with retinal pathologies including diabetic retinopathy and retinal vein occlusions at Moorfields Eye Hospital participating in an Alleye home monitoring programme between April 2020 to November 2022. Postcodes were used to determine the Digital Exclusion Risk Index (DERI) and the Index of Multiple Deprivation (IMD) rebased for London. Clinical information from the electronic patient record and Alleye app usage data were extracted for each patient. Associations between the DERI/IMD, clinical parameters and app use were examined using multivariable regression models.
Results :
Mean DERI was 2.56 (standard deviation, SD=0.36), IMD was 6.25 (SD=2.79), Visual acuity (VA) in the better eye at study entry was 83.3 ETDRS letters (SD=7.9), and mean follow-up was 344.4 days (SD=260.1). During the observation period, 36% received an intravitreal injection (IVI) and VA fell by at least 10 letters in around 1 in 4 patients. In 87.5% of patients requiring IVI, use of the app increased. We found no association with clinical parameters and programme adherence for DERI or IMD.
Conclusions :
This home monitoring programme for mostly diabetic patients included people with a high digital exclusion risk and high social deprivation. Interestingly, there is no association between these parameters, clinical course and monitoring adherence, suggesting that patients with high digital exclusion risk and significant social deprivation may benefit from such a programme.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.