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Utilization and Abandonment of Low Vision Devices Prescribed on a Mobile Clinic

Gobeille, Micaela R., BS1; Malkin, Alexis G., OD, FAAO1; Jamara, Richard, OD, FAAO1; Ross, Nicole C., OD, MSc, FAAO1*

doi: 10.1097/OPX.0000000000001267

SIGNIFICANCE Device utilization and abandonment for patients seen on a mobile clinic are explored. Findings are informative for resource allocation in a novel low vision rehabilitation (LVR) delivery model. This study also explores the relationships between device abandonment and LVR patient-reported functional outcomes.

PURPOSE This prospective cohort study investigated low vision device utilization and abandonment in a novel mobile clinic delivery model.

METHODS A device abandonment questionnaire was administered by telephone 3 months and 1 year after mobile clinic LVR. Participants (n = 65) had previously met the U.S. definition of legal blindness and were prescribed a total of 154 devices at their low vision consultative visits. Trends in device utilization and correlations with clinical and demographic participant characteristics, as well as functional outcomes as assessed by Massof Activity Inventory, are explored.

RESULTS An average of 2.6 device recommendations were made per participant. Digital magnification, optical magnifiers, and filters were most frequently recommended. At 3 months, 29% of participants abandoned at least one device, although only 17% of received devices were abandoned. There was no significant difference in the number of devices used, abandoned, or not received at 3 months versus 1 year after LVR. Devices prescribed for reading goals were most frequently used and least often abandoned, whereas glare control and distance magnification devices were more frequently abandoned. Neither patient characteristics nor Massof Activity Inventory change score was predictive of device abandonment. There was no significant difference in the odds of device abandonment in comparison with a previous study that assessed academic outpatient LVR clinics using the same questionnaire.

CONCLUSIONS Although more device recommendations are given per patient on the mobile clinic, there is no significant difference in device abandonment for patients seen on the mobile clinic versus other outpatient LVR delivery models.

1New England College of Optometry, Boston, Massachusetts *

Submitted: January 4, 2018

Accepted: May 22, 2018

Funding/Support: National Institutes of Health (T35EY007149; to MRG); Beta Sigma Kappa (to MRG); Minnie Flaura Turner Fund for Impaired Vision Research (to MRG); American Academy of Optometry (Edward I. Goodlaw Student Travel Fellowship; to MRG); and Massachusetts Commission for the Blind (Mobile Clinic Support Grant).

Conflict of Interest Disclosure: The corresponding author, Prof. Nicole C. Ross serves as a consultant for Genentech and has served on Advisory Boards for Genentech Inc. Prof. Ross has received honoraria and travel support from Genentech as part of her participation on the advisory board. Genentech has no involvement in this project.

Author Contributions and Acknowledgments: Conceptualization: RJ, NCR; Data Curation: MRG, NCR; Formal Analysis: MRG; Funding Acquisition: MRG, RJ, NCR; Investigation: MRG, AGM, RJ, NCR; Methodology: MRG, NCR; Project Administration: AGM, NCR; Resources: AGM, NCR; Software: NCR; Writing – Original Draft: MRG; Writing – Review & Editing: MRG, AGM, NCR.

The authors would like to acknowledge the contribution of Gary Chu, OD, MPH, FAAO, to this work.

© 2018 American Academy of Optometry