Barriers and enablers to low vision care services in a tertiary eye care hospital: A mixed method study

Abstract

Purpose: Visual impairment is a major health concern all over the world. Globally, it has been studied that utilization of low vision care (LVC) services varies from 3% to 15%. This study describes barriers to access the LVC services and suggest enablers to improve the uptake of services in a tertiary eye care hospital. Methods: A snapshot qualitative research design with purposive sampling was adopted. Qualitative part of the study involved 13 eye care practitioners (ECPs) and 7 patients with low vision participated in one to one in-depth interviews. The interviews were audio recorded, transcribed, inductively coded, and analyzed. The barriers to access LVC services were identified and enablers to improve the uptake of services were implemented. The referral rate and utilization of LVC services were analyzed in the quantitative part. Results: Themes emerged out of qualitative part of the study were barriers, perceived benefits, and enablers to improve the uptake of LVC services. Barriers among ECPs included lack of awareness on referral criteria and available LVC. Barriers among patients were lack of knowledge and understanding about the need for services. The enablers included development of referral criteria and referral pathway to LVC services, creating awareness of LVC services to patients and ECPs, stratification levels of LVC services, and implementation of LVC counseling chamber. Referral rate improved from 25.6% to 51.2% and the utilization of services increased from 67.9% to 81.7% after implementation of the recommended enablers. Conclusion: Execution of stratified enablers increased the uptake of LVC services benefiting more number of people with low vision in this study.

Assessment of Low Vision Referrals before and after Establishment of a Low Vision Program at an Academic Medical Center

“…This study looked at barriers and enablers to low-vision services in a tertiary eye care hospital and concluded that creating awareness in the community and among eye care providers improved acceptance of low-vision services and increased referral rates. 18 Our referral rate remains lower than the final referral rate cited in this study. This is most likely because our only enabler was establishing a low-vision rehabilitation service.…”

“…However, we have seven satellite clinics, and we plan to focus on adding low-vision services in the future to increase referral rates. Sarika et al 18 examined the perceived barriers to patients successfully undergoing low-vision rehabilitation. The most prominent barriers among eye care providers were lack of understanding of appropriate referral criteria and lack of availability of low-vision services.…”

Barriers to Low-Vision Rehabilitation Services for Visually Impaired Patients in a Multidisciplinary Ophthalmology Outpatient Practice

“…Counseling patients in the presence of a family member, especially in patients with cognitive impairment, will help patients and families understand the benefits of LVR and may further motivate them to utilize the services. Sarika et al proposed establishing a counseling chamber, where explanation of the ocular condition, visual prognosis, and available LVR services can be explained to low-vision patients [ 21 ]. A multidisciplinary approach with the primary care providers, occupational therapists, social workers, and counselors will further assist in providing better LVR access to patients with mental health issues and lack of social support.…”

Barriers to Low Vision Services Among Optometrists in Saudi Arabia

“…Studies have suggested that the barriers included lack of awareness on referral criteria, availability of LV clinics, misconceptions on LV services, miscommunication by eye care professionals, clinic location and transportation, the need to feel independent, negative societal views about LV services, discouragement from family and friends, cost of LV aids, and reduced perception of vision loss in relation to other losses in life [48 -50]. Patients' enablers included structured referral criteria and referral pathways to LV clinics and patient opportunities to be aware of LV services [49,51]. These barriers and enablers should be tackled at all levels, including health institutions, non-governmental support groups, and all health professionals related to the LV field.…”