Effect of rehabilitation worker input on visual function outcomes in individuals with low vision: study protocol for a randomised controlled trial

Abstract

BackgroundVisual Rehabilitation Officers help people with a visual impairment maintain their independence. This intervention adopts a flexible, goal-centred approach, which may include training in mobility, use of optical and non-optical aids, and performance of activities of daily living. Although Visual Rehabilitation Officers are an integral part of the low vision service in the United Kingdom, evidence that they are effective is lacking. The purpose of this exploratory trial is to estimate the impact of a Visual Rehabilitation Officer on self-reported visual function, psychosocial and quality-of-life outcomes in individuals with low vision.Methods/designIn this exploratory, assessor-masked, parallel group, randomised controlled trial, participants will be allocated either to receive home visits from a Visual Rehabilitation Officer (n = 30) or to a waiting list control group (n = 30) in a 1:1 ratio. Adult volunteers with a visual impairment, who have been identified as needing rehabilitation officer input by a social worker, will take part. Those with an urgent need for a Visual Rehabilitation Officer or who have a cognitive impairment will be excluded. The primary outcome measure will be self-reported visual function (48-item Veterans Affairs Low Vision Visual Functioning Questionnaire). Secondary outcome measures will include psychological and quality-of-life metrics: the Patient Health Questionnaire (PHQ-9), the Warwick-Edinburgh Mental Well-being Scale (WEMWBS), the Adjustment to Age-related Visual Loss Scale (AVL-12), the Standardised Health-related Quality of Life Questionnaire (EQ-5D) and the UCLA Loneliness Scale. The interviewer collecting the outcomes will be masked to the group allocations. The analysis will be undertaken on a complete case and intention-to-treat basis. Analysis of covariance (ANCOVA) will be applied to follow-up questionnaire scores, with the baseline score as a covariate.DiscussionThis trial is expected to provide robust effect size estimates of the intervention effect. The data will be used to design a large-scale randomised controlled trial to evaluate fully the Visual Rehabilitation Officer intervention. A rigorous evaluation of Rehabilitation Officer input is vital to direct a future low vision rehabilitation strategy and to help direct government resources.Trial registrationThe trial was registered with (ISRCTN44807874) on 9 March 2015.

Effect of a Home Visit–Based Low Vision Rehabilitation Intervention on Visual Function Outcomes: An Exploratory Randomized Controlled Trial

“…The methods for this trial have been described in detail elsewhere. 18 Briefly, this study was an exploratory, assessormasked, individually randomized, single-center controlled trial. Participants were allocated to the intervention or a waiting list arm of the trial in a 1:1 ratio over an 18-month period.…”

“…A description of the specific training and support in each area of need is detailed elsewhere. 18 During the trial, all participants had access to hospital-and community-based low vision optometric assessments, such that the control and intervention groups differed only in the receipt of the visual rehabilitation officer intervention. For each participant allocated to the intervention arm, the number and type of intervention items and the number of visits were recorded.…”

Cost‐effectiveness of basic vision rehabilitation (The basic VRS‐effect study): study protocol for a randomised controlled trial

“…We will provide a list of instructions on how to minimise the effect of reduced vision during activities of daily living, see Appendix S4, Table with instructions. [50][51][52][53][54] During the in-office training, participants will receive a supervised training session with their devices as given in Table 2, a large print version of the list is provided to take home. 48,55,56 The intervention will be followed by a telephone call to ensure that participants are using their devices.…”