Improved Adherence to Vision Self-monitoring with the Vision and Memory Stimulating (VMS) Journal for Non-neovascular Age-related Macular Degeneration during a Randomized Controlled Trial.
Improved Adherence to Vision Self-monitoring with the Vision and Memory Stimulating (VMS) Journal for Non-neovascular Age-related Macular Degeneration during a Randomized Controlled Trial.
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DOI：
10.4172/2155-9570.1000320
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发表时间：
2014-01-22
期刊：
影响因子：
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通讯作者：
Roser M
中科院分区：
文献类型：
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作者：
Bittner AK;Torr-Brown S;Arnold E;Nwankwo A;Beaton P;Rampat R;Dagnelie G;Roser M
开发了一种教育、互动杂志[视觉和记忆刺激(VMS)杂志]，以增强患者的信心，并促进对有新发新生血管导致视力丧失风险的年龄相关性黄斑变性(AMD)患者进行每周视力自我监测。在一项多中心随机对照试验中，198名患有中期、非新生血管性AMD的受试者接受VMS杂志或遵循常规护理(例如，他们的医生关于视力监测的说明；Amsler GRID)。在注册后6个月和/或12个月，157名受试者完成了关于视力自我监测的问卷调查。在6个月和12个月时，分别有85%和80%的VMS期刊受试者报告至少每周一次的视力监测，这在统计学上具有统计学意义，比在两次随访中每周监测一次的对照组的50%分别高7.1%和4.2%(p<；0.001)。分别在6个月和12个月时，29%和25%的对照组表示他们在过去6个月内没有检查过视力，而VMS杂志的受试者中只有1.5%和5%的人报告没有视力自我监测。在6个月和12个月时，分别只有15%和13%的VMS期刊受试者报告说，他们不相信自己通过自我监控来照顾自己的视力(p<；0.001)。在6个月和12个月时，常规护理对照组报告不信任的几率分别是对照组的6.7倍和5.0倍，具有统计学意义。两组之间每周自我监测的频率与频率较低的自我监测相比没有统计学上的显著变化(p=0.68)，所有受试者中有81%的人报告在6至12个月期间频率没有变化。这些发现支持了VMS杂志在提高视力自我监测的依从性和信心方面的有效性，此外还促进了对有渗出性视网膜变化风险的AMD受试者一年中每周监测的持久性。
An educational, interactive journal [Vision and Memory Stimulating (VMS) journal] was developed to boost patient confidence and promote long-term adherence with weekly vision self-monitoring in age-related macular degeneration (AMD) patients at risk for vision loss from new-onset neovascularization. In a multicenter randomized controlled trial, 198 subjects with intermediate stage, non-neovascular AMD received the VMS journal or followed usual care (e.g. their doctor’s instructions for vision monitoring; Amsler grid). At 6 and/or 12 months post-enrollment, 157 subjects completed a questionnaire on vision self-monitoring. At 6 and 12 months, respectively, 85% and 80% of the VMS journal subjects reported vision monitoring at least weekly, which represent statistically significant 7.1 and 4.2 times greater odds than the 50% of controls who monitored weekly at both follow-up times (p<0.001). At 6 and 12 months, respectively, 29% and 25% of controls indicated that they had not checked their vision in the past 6 months, while only 1.5% and 5% of the VMS journal subjects reported no vision self-monitoring. At 6 and 12 months, respectively, only 15% and 13% of the VMS journal subjects vs. 53% and 44% of the controls reported that they did not feel confident that they were taking care of their sight by self-monitoring (p<0.001). Usual care controls had statistically significant 6.7 and 5.0 times greater odds of reporting non-confidence at 6 and 12 months, respectively. There was no statistically significant change in weekly vs. less frequent self-monitoring between the groups (p=0.68), with 81% of all subjects reporting no change in frequency between 6 and 12 months. These findings support the efficacy of the VMS journal for increasing vision self-monitoring adherence and confidence, in addition to promoting persistence in weekly monitoring over the course of a year in AMD subjects at risk for exudative retinal changes.