Philadelphia Telemedicine Glaucoma Detection and Follow-Up Study

Summary

Participation Requirements

Description

The project will be divided into following parts: Phase 1 will consist of recruiting approximately 900 patients from primary care offices and federally qualified health centers across Philadelphia and Chester counties. Using telemedicine, we will detect eye disease at Visit 1, followed by a comprehe...

The project will be divided into following parts: Phase 1 will consist of recruiting approximately 900 patients from primary care offices and federally qualified health centers across Philadelphia and Chester counties. Using telemedicine, we will detect eye disease at Visit 1, followed by a comprehensive eye exam by a glaucoma specialist in the primary care setting to confirm the diagnosis (Visit 2). Based on preliminary data, 50% of patients will have abnormal optic nerve and/or macular images. The predictive accuracy of the optic nerve images to detect glaucoma, glaucoma suspect and other eye diseases as confirmed by the comprehensive eye exam will be evaluated. Phase 2 will involve consenting, enrolling, and randomizing 343 patients to either the usual care group (n=171) or the enhanced intervention group (n=172) and scheduling follow-up eye exams with a local, general ophthalmologist in an office-based setting (Visit 3). The enhanced intervention will consist of using patient navigators and a social worker to reduce barriers to follow-up eye care. Phase 3 will involve following patients for proximal (1-2 months) and distal (3 years) follow-up care appointments (Visits 3-8) with a local ophthalmologist. Adherence to follow-up recommendations for eye care will be the primary outcome measure. A comprehensive cost study to estimate the intervention costs and cost-effectiveness of detecting eye diseases and vision impairment in a high-risk population will also be conducted. Protocols, materials, and results will be disseminated to other organizations, stakeholders and communities in order to expand detection of glaucoma, other eye diseases, and visual impairment, and to further refine these approaches.

Tracking Information