Access to low‐vision rehabilitation services: barriers and enablers

Abstract

Background:The current mismatch between the need for and uptake of low-vision services has been attributed to various barriers including different service delivery models and referral pathways. This study evaluates the referral pathway and low-vision service provision of the Royal Society for the Blind (RSB) in South Australia. Methods: All new referrals from the 2008-2009 financial year to the RSB were reviewed. Initially, patients were contacted by a triage officer within one week of referral. Initial appointments were made in the Low Vision Clinic with a multidisciplinary team. Reasons for declining the appointment or non-attendance were tracked via telephone. Results: There were 1116 patients referred over a 12-month period and 1082 (97 per cent) were reviewed in the Low Vision Clinic. Most attendees (92 per cent) lived within 50 kilometres of the clinic. There were 34 referred patients, who declined or did not attend the assessment. All non-attendees also lived within 50 kilometres of the Low Vision Centre. Concurrent major health problems (27 per cent) and patients not feeling the need for low-vision rehabilitation (27 per cent) were the most common reasons for not accessing the service. Only 125 patients (11.6 per cent) accessed volunteer transport services and only 24 patients (2.2 per cent) needed an interpreter service. Conclusion:The attendance rate is significantly higher than in other published studies. The distance to travel or transport difficulties were not significant barriers. Patient perception that either the service was not required or would not help them was the main barrier. The referral and triage process appeared to be a major enabler of low-vision service uptake.

Advancing low vision services: A plan for Australian optometry

“…At the first meeting members brainstormed ideas on the goals that would advance low vision service delivery and the current barriers to optometrists providing low vision services in Australia. Ideas included those derived from a preliminary review of Australian studies on barriers . A nominal group technique was used to ensure that all members contributed.…”

“…At the second meeting, using the nominal group technique, members brainstormed ideas on solutions to barriers and increasing the involvement of optometrists in providing low vision services, including those obtained from a preliminary review of Australian studies and literature . As before, ideas were collated by the convenor and listed in random order.…”

“…Ideas included those derived from a preliminary review of Australian studies on barriers. 6,[9][10][11] A nominal group technique was used to ensure that all members contributed. The meeting was held via teleconference and those who could not attend were asked to contribute via email.…”

“…At the second meeting, using the nominal group technique, members brainstormed ideas on solutions to barriers and increasing the involvement of optometrists in providing low vision services, including those obtained from a preliminary review of Australian studies and literature. 6,[9][10][11]13 As before, ideas were collated by the convenor and listed in random order. Members were asked to rank the importance of each solution on a scale from 1 to 5 (where 1 = very low, 2 = low, 3 = moderate, 4 = high, 5 = very high), rank the feasibility of achieving each solution on a scale from 1 to 3 (where 1 = difficult, 2 = moderate, 3 = easy) and nominate when each solution should be achieved (never, in the short-term, medium-term or long-term).…”

Low‐vision care: we are doing better but not well enough

“…Privately practising optometrists should be managing the majority of low‐vision patients with moderate low vision and should have established referral networks for counselling and other support services. They should be more assertive in taking on the role of case planning and management of low‐vision patients: no one else is doing it, although Matti and colleagues 10 in this issue describe a pro‐active referral pathway used by the Royal Society for the Blind in South Australia that seems to ensure that almost all referred patients attend for initial low‐vision assessment.…”