Characterization of problems associated with vision impairment and utility of the current interventions

ISRCTN ISRCTN10894889
DOI https://doi.org/10.1186/ISRCTN10894889
Secondary identifying numbers N/A
Submission date
18/12/2018
Registration date
21/01/2019
Last edited
14/11/2022
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Eye Diseases
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
The burden caused by vision loss can be reduced using targeted vision rehabilitation. Vision rehabilitation is intended to promote the best possible functional ability and the individual's ability to maintain their skills. However, there is still a lack of knowledge regarding the “value-for-money” of vision rehabilitation not only for people with impaired vision but also for the society. The aim of this study is to estimate the cost-effectiveness (value-for-money) of vision rehabilitation by measuring the consequences of rehabilitation for visual ability (visual ability is defined as the overall ability to perform activities that depends on vision).

Who can participate?
Adults diagnosed with diabetic retinopathy (DR) or age-related macular degeneration (AMD) with visual acuity between 0.4 - 0.1 (decimal scale) in the better-seeing eye. Participants must live in the community (not in nursing homes or other types of institution).

What does the study involve?
The study intervention consists of dispensing new glasses and magnifiers, defined as "vision aids" with minimal training. Instructions are provided in clinical settings with emphasis on reading tasks. Participants randomly allocated to the immediate intervention group receive the device in the first visit. Participants in the delayed intervention group receive the device after 3 months, in the second visit. All participants have a follow-up assessment at 3 month and at 9 months after receiving vision aids. During visits participants also need to response to questionnaires and to perform vision tests (none of them are invasive).

What are the possible benefits and risks of participating?
This study brings benefits to all participants because they will receive a basic vision rehabilitation intervention which includes new glasses and/or magnifiers with minimal training and instructions provided in clinical settings with emphasis on reading tasks. With the intervention procedures the patients won’t be exposed to any risk.

Where is the study run from?
The study is being run by the University of Minho and takes place in a single centre, a public hospital in Barcelos, Portugal

When is the study starting and how long is it expected to run for?
September 2016 to December 2021

Who is funding the study?
The ophthalmic lenses and part of the magnifiers are supported by Essilor Portugal

Who is the main contact?
1. Antonio Filipe Macedo
a.macedo@ucl.ac.uk; antonio.macedo@lnu.se
2. Laura Moreno
PhD student in University of Minho, Braga, Portugal

Contact information

Dr Antonio Filipe Macedo
Scientific

Linnaeus University
Department of Medicine and Optometry
Smålandsgatan 26 A
Kalmar
39234
Sweden

ORCiD logoORCID ID 0000-0003-3436-2010
Phone +351 (0)768805972
Email a.macedo@ucl.ac.uk
Miss Laura Moreno
Scientific

University of Minho
Departmento de Fisica
Campus de Gualtar
Braga
4710 - 057
Portugal

ORCiD logoORCID ID 0000-0001-6623-9151

Study information

Study designRandomised cross-over controlled trial
Primary study designInterventional
Secondary study designRandomised cross over trial
Study setting(s)Hospital
Study typeOther
Participant information sheet Not available in web format, pelase use contact details to request a participant information sheet
Scientific titleCost-effectiveness of basic vision rehabilitation services (the basic VRS-effect study): a cross-over randomised controlled trial
Study acronymThe basic VRS-effect study
Study objectivesThe aim of the trial is to compare the effects and costs of “usual low vision care” with a “basic vision rehabilitation service (basic VRS)” on self-reported visual ability.

Hypothesis: A basic low vision intervention, consisting of prescription of new glasses, magnifiers and instructions, improves visual ability more than usual care.
Ethics approval(s)Life Sciences and Health of the University of Minho, 02/05/2017, ref: SECVS 147/2016

CEUM/SECVS – Secretariado
Att: Isabel Monteiro
Universidade do Minho – Reitoria
Campus de Gualtar, CPII, Piso 3
4710-057 Braga
Tel: +351 (0)253 601 700
Email: secvs@reitoria.uminho.pt

Registered in the Portuguese data protection authority, ref: 7012/ 2017
Health condition(s) or problem(s) studiedVision impairment caused by diabetic retinopathy or age-related macular degeneration
InterventionTo perform a cost-effectiveness analysis (CEA) of basic VRS the trialists designed a randomised, cross-over controlled trial (AB/BA structure), comparing the effects and costs of “usual low vision care” (which is not yet systematised in Portugal) with a “basic-VRS intervention” on self-reported visual ability.

Participants will be allocated to the immediate intervention group (IMI), which is represented by group A or to a delayed intervention group (DEI) represented by group B. Participants are allocated to the IMI or DEI to create the best possible match between the groups according to age and visual acuity. The sequence of randomization is done blocks of 4 to guarantee two participants for each group using four similar envelopes. Each envelope will contain the code of the group, two envelopes for IMI and two for DEI group. The study takes place in a single-centre.

The intervention consists of dispensing new glasses and magnifiers, defined as "vision aids", with minimal training and instructions provided in clinical settings with emphasis on reading tasks. Participants allocated to the immediate intervention group will receive the device in the first visit. Participants in the delayed intervention group will receive the device after 3 months, in the second visit. All participants will have a follow-up assessment at 3 months and at 9 months after receiving vision aids.
Intervention typeDevice
Pharmaceutical study type(s)
Phase
Drug / device / biological / vaccine name(s)
Primary outcome measureMeasured at baseline, 12 weeks and 36 weeks:
1. Visual ability, measured using Massof Activity Inventory (AI)
2. Health-related quality of life, measured using EQ-5D-5L
Secondary outcome measuresMeasured at baseline, 12 weeks and 36 weeks:
1. Reading ability, measured using Portuguese version of Minnesota Low-Vision Reading Test (MNread test)
2. Depression and anxiety, measured using Hospital Anxiety and Depression Scale (HADS)
Overall study start date02/09/2016
Completion date31/12/2021

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participants88 participants (44 per group).
Total final enrolment47
Key inclusion criteria1. Visual acuity between 0.4 - 1.0 logMAR (0.4 - 0.1 decimal) in the better-seeing eye
2. Primary diagnosis (cause of vision loss) diabetic retinopathy or age-related macular degeneration
3. 18 years of age or older
4. Resident in the community (not in nursing homes or other types of institution)
Key exclusion criteria1. Cognitive impairment based on scores on mini-mental examination test
2. Communication problems due to, for example, hearing impairment, or unable to speak Portuguese
3. Unable to read in Portuguese due to low level of education
4. Unable to attend the requested appointments at the study setting
Date of first enrolment03/03/2017
Date of final enrolment30/03/2020

Locations

Countries of recruitment

  • Portugal

Study participating centre

University of Minho
Campus de Gualtar
Braga
4710-057
Portugal

Sponsor information

University of Minho
University/education

Department of Physics
Braga
4710-057
Portugal

Website https://www.uminho.pt/PT
ROR logo "ROR" https://ror.org/037wpkx04

Funders

Funder type

Other

Investigator initiated and funded

No information available

Results and Publications

Intention to publish date01/03/2022
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryData sharing statement to be made available at a later date
Publication and dissemination planPlanned publication:
Protocol: 29/03/2019
Results: 2019, 2020, 2021
IPD sharing planThe data sharing plans for the current study are unknown and will be made available at a later date.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Protocol article protocol 01/05/2020 14/02/2020 Yes No
Interim results article Association between social support and depression and anxiety 03/03/2021 07/09/2021 Yes No
Interim results article Association between depression and anxiety and health-related quality of life 10/02/2022 25/07/2022 Yes No
Results article 11/11/2022 14/11/2022 Yes No

Editorial Notes

14/11/2022: Publication reference added.
25/07/2022: Publication reference added.
18/10/2021: The total final enrolment number was added and the intention to publish date was changed from 30/09/2021 to 01/03/2022.
07/09/2021: The overall trial end date was changed from 30/09/2020 to 31/12/2021.
14/02/2020: Publication reference added.