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| ID | Type | Description | Link |
|---|---|---|---|
| 869353 | Other Grant/Funding Number | Velux Foundation |
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In this cohort study, the investigators will test vision screenings in Danish general practice for patients over 70 years of age with minimum one chronic condition. The main outcome is detection of vision impairment and secondary outcome is detection of conditions needing ophthalmologic follow-up but not presenting vision impairment at present time.
Introduction: The number of people living with visual impairment is increasing. Visual impairment causes loss in quality of life and reduce self-care abilities. The burden of disease is heavy for people experiencing visual impairment and their relatives. The severity and progression of age-related eye diseases are dependent on the time of detection and treatment options, making timely access to healthcare critical in reducing visual impairment. General practice plays a key role in public health by managing preventive healthcare, diagnostics and treatment of chronic conditions. General practitioners (GPs) coordinate services from other healthcare professionals. More involvement of the primary sector could potentially be valuable in detecting visual impairment.
Methods: Investigators apply the Medical Research Council framework for complex interventions to develop a primary care intervention with the GP as a key actor, aimed at identifying and coordinating care for patients with low vision. The development process will engage patients, relatives and relevant health professional stakeholders. The investigators will pilot test the feasibility of the intervention in a real-world general practice setting. The intervention model will be developed through a participatory approach using qualitative and creative methods such as graphical facilitation. The project aims to explore the potentials and limitations of general practice in relation to detection of preventable vision loss.
Ethics and dissemination: Ethics approval is obtained from local authority and the study meets the requirements from the Declaration of Helsinki. Dissemination is undertaken through research papers and to the broader public through podcasts and patient organisations.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Three vision tests in general practice | Other | All patients recruited in general practice are asked to fill out a patient questionnaire and examined: - Collenbrander Mixed contrast card: testing near vision binocularly at 40 cm, using both 100% and 10% contrast. - Amsler Test: Conducted for both eyes to check for central vision issues. - Visual Field Test: Performed using the Donders method to assess peripheral vision, conducted for both eyes. After tests in general practice, all patients undergo a comprehensive vision assessment at local optician shops, which include the following tests:
A project ophtalmologist analyze patient-data from optometrists. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| focus on vision impairment in older patients in general practice | Other | GP or GP nurse carry out the three vision tests. All patients visit optician shop collaborating with the project. An ophthalmologist review data from optometrists and provide an epicrisis to general practice. In case of acute conditions, the ophthalmologist is responsible for expedient treatment. If the patient needs further control by ophthalmologist within 12 month waiting time, general practice are responsible for referring the patient. |
| Measure | Description | Time Frame |
|---|---|---|
| Recruitment feasibility | Total number of patients invited to participate in the study based on the exclusion sheet and the proportion of eligible patients included by GP staff | From invitation to participate to enrollment within 4 weeks |
| Adherence | Proportion of patients who complete the intervention elements in general practice. | From enrollment to completion of GP intervention within 3 weeks. |
| Adherence | Proportion of patients completing vision tests in an optometrist setting. | From enrollment to completion of optometrist testing within 5 months. |
| Acceptability | Patient and health providers experiences and acceptability of the DETECT intervention | From enrollment to interview within 12 months. |
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| Measure | Description | Time Frame |
|---|---|---|
| GP staff assessment of patient vision pre- and post-the three vision tests compared with ophthalmologist evaluation | pre- and post test assessment by GP staff. Pre-test assessment is based on prehand knowledge of the patient and observations in the clinic before the DETECT vision tests post-test assessment is based on the results of the DETECT visiontests Both assessments are entered into a questionnaire through surveyXact |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Catharina Thiel Sandholdt, phd | Contact | +4531646460 | casa@sund.ku.dk | |
| Frans Boch Waldorff, prof | Contact | fransw@sund.ku.dk |
| Name | Affiliation | Role |
|---|---|---|
| Frans B Waldorff | Center for Almen Medicin, KU | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| GP practices | Recruiting | Copenhagen | Capital Region | Denmark |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37247966 | Result | Sandholdt CT, Jonsson ABR, Reventlow S, Bach-Holm D, Line K, Kolko M, Jacobsen MH, Mathiesen OH, Waldorff FB. DETECT: DEveloping and testing a model to identify preventive vision loss among older paTients in gEneral praCTice - protocol for a complex intervention in Denmark. BMJ Open. 2023 May 29;13(5):e069974. doi: 10.1136/bmjopen-2022-069974. | |
| 42161554 |
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GP's or GP nurses, optometrists and the project ophtalmologist all give their anamnesis (and potential diagnosis). Their anamnesis are blinded to each other
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| From enrollment to the ophthalmologist evaluation within 6 months. |
| Patient-reported assessment of vision in baseline questionnaire compared with ophthalmologist evaluation | Patient reported outcome measure compared with ophthalmologist evaluation | From enrollment to the ophthalmologist evaluation within 6 months. |
| Patients with vision reduction or signs of eye diseases detected at the vision tests by GP staff | • Reduced vision: The proportion of patients with binocular near visual acuity <0.7 (decimal value), assessed in a general practice setting using the Colenbrander near vision test while wearing habitual reading glasses. OR • Reduced contrast vision: The proportion with a difference of 4 or more lines between high-contrast and low-contrast Colenbrander near visual acuity with binocular vision. The normality cutoff defined as 2-3 lines difference. OR • Central visual defects indicating macular pathology e.g. wet AMD: The proportion of patients with a positive Amsler grid test, tested monocular. OR • Peripheral vision loss indicating e.g. glaucoma: The proportion of patients with abnormal findings on confrontational visual field testing, tested monocular. OR • Indication of reduced vision or eye disease: The proportion of patients with at least one of the above | From enrollment to completion of GP intervention within 3 weeks. |
| Ophthalmologist assessment of potential benefit of new distance correction or need for ophthalmological review and possible treatment | The proportion of patients for whom the ophthalmologist, based on data provided by the optometrist, assessed that a new distance correction would provide clinical benefit. Benefit was defined as an improvement of more than two lines in visual acuity, with a baseline binocular distance visual acuity <0.7. This includes the proportion of included patients requiring ophthalmological follow-up and possible treatment | From optometrist testing to ophthalmologist evaluation within 4 weeks. |
| GP practices | Recruiting | Køge | Region Sjælland | Denmark |
|
| Brost AG, Petersen ML, Steinbo EKF, Siersma V, Bach-Holm D, Line K, Kristensen M, Waldorff FB, Sandholdt CT. Detection of age-related vision reduction in general practice in Denmark (DETECT): a study protocol for a feasibility and cohort study. BMJ Open. 2026 May 20;16(5):e115062. doi: 10.1136/bmjopen-2025-115062. |
| ID | Term |
|---|---|
| D014786 | Vision Disorders |
| D001766 | Blindness |
| D005901 | Glaucoma |
| D008268 | Macular Degeneration |
| D002386 | Cataract |
| D003930 | Diabetic Retinopathy |
| ID | Term |
|---|---|
| D012678 | Sensation Disorders |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D005128 | Eye Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D009798 | Ocular Hypertension |
| D012162 | Retinal Degeneration |
| D012164 | Retinal Diseases |
| D007905 | Lens Diseases |
| D003925 | Diabetic Angiopathies |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D048909 | Diabetes Complications |
| D003920 | Diabetes Mellitus |
| D004700 | Endocrine System Diseases |
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