Tele I CARE for Seniors A Teleophthalmology Vision Health Surveillance Service

Tele I CARE for Seniors 远程眼科视力健康监测服务

• 批准号: 8917846
• 负责人: Rajeev Ramchandran
• 金额: $ 11.17万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-01 至 2016-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8917846
• 关键词: Academy; Accounting; Age; Aging; American; Anxiety; Assisted Living Facilities; Awareness; Blindness; Budgets; Caring; Clinic; Communities; Contrast Sensitivity; Data; Diabetes Mellitus; Diabetic Retinopathy; Diagnostic; Disease; Early Diagnosis; Economic Burden; Education; Elderly; Eye; Eye diseases; Feasibility Studies; Focus Groups; Goals; Health; Health Insurance; Healthcare; Image; Impairment; Improve Access; Independent Living; Individual; Institutes; Intention; Internet; Interview; Knowledge; Leadership; Learning Module; Life; Link; Living Costs; Logistics; Measures; Medical; Medical Fees; Medical Records; Medicare; Mental Depression; Modeling; Motivation; Nursing Homes; Ophthalmic examination and evaluation; Ophthalmologist; Ophthalmology; Outcome; Pain; Pathology; Patient Education; Patients; Phase; Physiologic Intraocular Pressure; Population; Prevention; Preventive; Primary Health Care; Procedures; Provider; Quality of life; Reading; Recommendation; Reporting; Research; Research Project Grants; Resources; Retinal; Secure; Self Care; Services; Site; Societies; Specialist; Surveillance Program; Surveys; Testing; Transportation; Vision; Vision Screening; Visual impairment; Vulnerable Populations; Work; Writing; age related; aged; base; community living; cost; design; diabetic; digital; health care delivery; improved; inner city; older patient; patient oriented; population health; programs; response; screening; skills; success

DESCRIPTION (provided by applicant): Eye disease and vision impairment are more prevalent in the aged population, especially those in senior living communities, such as assisted or independent living. Older patients with visual impairment are more likely to have severe problems with daily activities, mobility, pain, and discomfort, anxiety, depression, and self-care. By 2030, 50% of seniors will have at least one visually significant ocular disease that could account for about 50% of the health care budget for older adults. Medicare expenses for non-vision-related medical care are 50% higher for those with vision loss than for those without. Fortunately vision loss from the majority of age-related eye conditions can be treated and/or avoided with appropriate preventive measures -- especially if detected early. Thus, there is both a quality of life and cost-advantage to early detection of eye disease among seniors. However, at best, only 60% of the insured Medicare population has regular eye exams. The purpose of this study is to determine whether providing remote diagnostic screenings for vision impairment and eye disease using retinal cameras combined with personalized patient education is feasible and acceptable for older adults in senior living settings. Feasibility of improving access to visio care in this vulnerable population is tested as well. We expect this service to be well received in older adult residential settings based on our current work in using a similar strategy to improve diabetic retinopathy screening rates in inner city primary care clinics. The proposed non-randomized feasibility study aims to develop and implement a teleophthalmology surveillance program in senior living communities (Aim 1); establish feasibility and acceptability of the teleophthalmology model at both the resident and facility level through focus groups and qualitative staff and leadership interviews about impact on facility work flow and resources (Aim 2); and obtain preliminary estimates in four major outcomes: (a) residents' knowledge about eye health assessed by a pre and post multiple choice test (b) residents' motivation to take care of their eye health, and (c) diabetic residents reported intention to see the eye doctor at least annually assessed by directly questioning the , (d) level of vision impairment and eye pathology in an elder residential setting as identified by the screening values and PI review of ocular imaging. (Aim 3) Our Tele-I-CARE for Seniors model has the potential to 'produce patient- centered, timely and effective care that reduces the financial impact and economic burden to society caused by vision problems.'

描述(申请人提供)：眼疾和视力障碍在老年人中更为普遍，特别是那些生活在老年社区的人，如辅助生活或独立生活。患有视力障碍的老年患者更有可能在日常活动、活动、疼痛、不适、焦虑、抑郁和自我照顾方面存在严重问题。 到2030年，50%的老年人将至少患有一种严重的眼部疾病，这可能占老年人医疗保健预算的50%左右。失明患者的非视力相关医疗费用比非失明患者高出50%。幸运的是，通过适当的预防措施，可以治疗和/或避免大多数与年龄相关的眼睛疾病造成的视力丧失--特别是如果及早发现的话。因此，在老年人中及早发现眼病既有生活质量，又有成本优势。然而，充其量只有60%的医疗保险参保人口有定期的视力检查。这项研究的目的是确定使用视网膜摄像头结合个性化患者教育提供视力障碍和眼病的远程诊断筛查是否可行，是否适合老年人生活在老年生活环境中。还测试了在这一弱势群体中改善获得Visio护理的可能性。我们希望这项服务在#年受到好评。 老年人住宿环境基于我们目前的工作，使用类似的策略来提高市中心初级保健诊所的糖尿病视网膜病变筛查率。拟议的非随机可行性研究的目的是在老年生活社区制定和实施远程眼科监测方案(目标1)；通过重点小组和定性工作人员以及与领导人就对设施的工作流程和资源的影响进行访谈，在居民和设施一级确定远程眼科模式的可行性和可接受性(目标2)；并通过四项主要结果获得初步估计：(A)通过多项选择测试前后评估的居民对眼睛健康的了解；(B)居民照顾自己眼睛健康的动机；以及(C)糖尿病居民报告通过直接询问眼科医生至少一年来看眼科医生的意向，(D)通过筛查值和眼部成像PI审查确定的老年居住环境中的视力损害程度和眼部病理。(目标3)我们为老年人提供的Tele-i-care模式有可能“产生以患者为中心的、及时和有效的护理，减少视力问题对社会造成的经济影响和经济负担。”

项目成果

Association of vision loss and depressive symptomatology in older adults assessed for ocular health in senior living facilities.

在老年生活设施中评估老年人视力丧失与抑郁症状之间的关系，评估其眼部健康状况。

• DOI: 10.1111/opo.12869
• 发表时间: 2021
• 期刊: Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)
• 作者: Silverstein,StevenM;Sörensen,Silvia;Sunkara,Anoop;Lai,Adriann;Fradkin,SamanthaI;Ramchandran,RajeevS
• 通讯作者: Ramchandran,RajeevS