Author(s): Bittner AK, TorrBrown S, Arnold E, Nwankwo A, Beaton P,
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Abstract OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
This article was published in J Clin Exp Ophthalmol
and referenced in Journal of Clinical & Experimental Ophthalmology