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APHA Scientific Session and Event Listing

Recorded presentation

Joan Stelmack, OD, MPH, Edward Hines VA Hospital, Blind Rehabilitation Center, Bldg. 113 (124), Hines, IL 60141, 708-202-2124, Joan.Stelmack@med.va.gov

Objective: An unmasked RCT is being conducted to evaluate the effectiveness of a new low vision program for veterans with vision loss secondary to macular diseases. Methods: Subjects include 122 veterans from Chicago and Salisbury NC. Veterans are randomized to treatment from the low vision outpatient program or a usual care control group. Veterans in the treatment group receive low vision exam, 5 therapy sessions at the local VA sites and one home visit to evaluate the home environment/set up prescribed devices. Low vision devices that are provided include: desk top model CCTVs, monocular telescopes, teleloupes, illuminated stands/reading glasses, pocket magnifiers and non-optical aids. Results: The primary outcome measure is change in reading domain scores on the VA LV VFQ-48 a telephone questionnaire where subjects self-report their difficulty performing daily living activities in the community. Other measures include: instructor's rating of veteran's visual skills and use of low vision devices after rehabilitation, visual skills for reading (PEPPER VSRT), health status (SF-36), and symptoms of depression (CES-D). Outcomes will be compared with T tests. Multiple linear regression models are being used to identify predictors and explain outcomes. Costs and cost effectiveness of outpatient treatment will be evaluated. Conclusions: This is one of the first RCTs to measure the effectiveness of a low vision rehabilitation program incorporating vision rehabilitation with electronic and optical low vision devices. Findings will contribute to the evidence base for CMS funding of low vision service delivery.

Acknowledgement: Funded VA Rehabilitation Research and VA Prosthetics Services

Learning Objectives: At the conclusion of this session, participants will

• recognize the need for clinical trials in low vision rehabilitation to guide evidence based practice and funding decisions
• describe instruments to measure low vision outcomes
• discuss a clinical trial in the Department of Veterans Affairs that is measuring outcomes of low vision service delivery.

Keywords: Clinical Trials, Quality of Care

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation