Smartphone screening and referral increases access to care for people with eye problems
Smartphone-based eye screening and referral systems used in the community nearly triple the number of people with eye problems attending primary care compared to standard approaches and are adequate for hospital services. It has been shown to increase usage. The new findings are from a survey conducted in Kenya. Lancet Digital Health..
The· Randomized controlled trial More than 128,000 people from Transzoia County, Kenya participated and were conducted by researchers at the London School of Hygiene and Tropical Medicine, Kitale County Hospital, Nairobi University, and Peak Vision’s International Center for Ophthalmology (ICEH).
The results show the potential to improve access to care using mHealth tools such as the Peek Community Eye Health System (Peek CEH) evaluated in this study. Eye health It provides resources and effectively manages more patients at the primary level so that hospitals can focus on more complex cases.
Low- and middle-income earners have a high prevalence of avoidable vision disorders due to restricted access to ophthalmic services and a shortage of ophthalmic care providers. Globally, more than 1.1 billion people have preventable or treatable vision problems, often with simple things like eyeglasses and cataract surgery. Key barriers to care include lack of access and awareness of ophthalmic services.
Peek CEH is a smartphone-based referral system that provides vision tests, SMS reminders for people who need follow-up appointments, and track patient movements to access follow-up care to see who is being treated. Contains real-time reports for. The system evaluated in this trial also incorporates a scientifically validated decision-making guide app 1 that allows non-expert community volunteers to accurately identify patients and refer them to ophthalmic services. I will.
In the trial, 36 community unit clusters (defined as the population of the health center and its catchment area) were randomly assigned and the Peek Community Eye Health System (Peek Community Eye Health System).Intervention group) Or a standard approach to health center-based outreach clinics (Control group).
In the intervention group, community volunteers used a decision-making guide app to assess participants’ eyesight through home-to-door screening. When screeners identified eye problems, participants were automatically referred for triage evaluation and received regular personalized SMS reminders about their appointments.
Community sensitization (posters and verbal notices in churches and schools) took place in both groups, and four weeks later a triage clinic was held at the linked medical facility. During the triage, participants from both groups were evaluated and treated and referred to the Kitale Ophthalmology Unit (hospital) if further treatment was needed. Participants in the intervention group received additional SMS reminders for hospital appointments.
Researchers found that the average attendance rate of triage by participants with eye problems was significantly higher in the intervention group where the peak community ophthalmic health system was used compared to the control group (10,000 participants in the intervention group). 1,429 per person, 522 per person) Difference in proportion of 10,000-906 per 10,000 in the control group). The average outpatient rate for people with eye problems was also high (82 per 10,000 in the intervention group, 33 per 10,000 in the control group, and 49 per 10,000).
Dr. Hillary Rono, a researcher at ICOH and Peek, the lead author of the study, and an ophthalmologist at Kitale Eye Hospital, said: Our findings show great potential for using the Peak Community Eye Health System to effectively maximize limited health resources.
“Our previous study found that community volunteers using the decision-making guide app were about as effective as experienced eyes in identifying and referencing patients with eye problems. It is shown. health professional. These new findings will allow more people to access the right level of care by using this app to assess the eyesight of people at home as part of the wider Peek CEH. It often indicates a change in life. “
Importantly, researchers found that increasing the number of people with eye problems accessing care does not mean that hospitals will be overwhelmed, as most patients (76%) were managed at the primary level. discovered. In fact, when the team compared the data from previous studies, the number of patients attending the hospital remained at the same level during the trial, but the hospital’s ophthalmic services were being used more effectively. understood.The percentage of people attending is much lower hospital for Eye problems While the proportion of patients treated for more serious conditions such as cataracts increased from 8% to 62.9%, it may have been treated at the primary level (17.1% under study vs. 61% previously observed). ..
Dr. Andrew Bastawrous, co-author of the study, CEO of PeekVision and ICEC researcher, said: “This study is very exciting because it shows the changes in the actual system. This change has enabled the right people to get the right services in the right places. Specialist services are overall. Despite the significant increase in demand, we have acquired the capacity needed to focus on more complex situations. As the population grows and ages, more and more people are left behind. I’m happy that this is evidence-based. An approach to tackling the growing vision crisis. “
The authors noted some study limitations, such as SMS message delivery errors considered through further data analysis, low overall screening coverage, and households to ensure that participants were at home. It suggests that other approaches to screening should be considered, such as repeated visits.
Effectiveness of mHealth System for Access to Kenya’s Ophthalmic Medical Services: Cluster Randomized Controlled Trials, Lancet Digital Health, www.thelancet.com/journals/lan… (21) 00083-2/fulltext
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