Using Telemedicine to Prevent Blindness in an At-Risk Rural Alabama Population

利用远程医疗预防阿拉巴马州农村高危人群失明

• 批准号: 10766885
• 负责人: Lindsay A Rhodes
• 金额: $ 70万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-30 至 2024-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10766885
• 关键词: Using; Telemedicine; Prevent; Blindness; Risk

Project Summary The number of primary open angle glaucoma (POAG) cases will increase by 250% by 2050, directly affecting over 7 million lives. These numbers are specifically for POAG and do not include the many who are monitored and treated for elevated intraocular pressure or for glaucoma suspect status, which along with POAG can all be considered glaucoma associated diseases (GAD). Development of high-quality, accessible, and cost-effective strategies for eye care for these individuals is of critical importance. POAG is at least 4-5 times higher in African Americans, progresses more rapidly and appears about 10 years earlier as compared to those of European descent. This research plan seeks to implement and evaluate a telemedicine-based detection and management strategy for GAD and other eye diseases in patients seen at Federally Qualified Health Centers (FQHC’s) located in the rural Alabama Black Belt Region. This region is characterized by one of the highest concentrations of African Americans in the US; high poverty, unemployment, and uninsured rates; inadequate educational systems, transportation and community resources; few optometrists who largely practice in retail settings; and no ophthalmologists specializing in glaucoma. We have developed and tested a novel multimodal telemedicine approach in our prior CDC- funded Eye Care Quality and Accessibility Improvement in the Community (EQUALITY) study that used comprehensive remote optic nerve assessment (RONA). This proposal will employ a modification of the EQUALITY approach using portable measurement of visual function and optic nerve and retinal structure that are more applicable to rural locations with limited resources. We will also identify and evaluate remediation strategies for the barriers to patient adherence with referral and follow-up appointments by comparing the effectiveness of financial incentives along with a validated patient education program versus a validated patient education program alone. Using this program within FQHC’s will enable expansion nationwide into rural and urban underserved locations as these centers provide primary health care services in underserved areas and treat more than 27 million people yearly at over 12,000 sites.

项目概要 原发性开角型青光眼 (POAG) 病例数量将增加 250% 到 2050 年，将直接影响超过 700 万人的生活。这些数字专门针对 POAG。 并且不包括许多因眼内升高而接受监测和治疗的人 压力或青光眼怀疑状态，与 POAG 一起都可以考虑 青光眼相关疾病（GAD）的开发。 对于这些人来说，具有成本效益的眼部护理策略至关重要。 非裔美国人的 POAG 至少高出 4-5 倍，进展更快并且 与欧洲血统的人相比，这个年龄大约早了10年。 研究计划旨在实施和评估基于远程医疗的检测和 联邦就诊患者的广泛性焦虑症和其他眼部疾病的管理策略 合格健康中心 (FQHC) 位于阿拉巴马州黑带地区乡村。 该地区是非洲裔美国人最集中的地区之一 美国；高贫困率、高失业率和无保险率； 系统、交通和社区资源；少数验光师主要 零售场所的执业；并且我们没有专门治疗青光眼的眼科医生。 在我们之前的 CDC 中开发并测试了一种新颖的多模式远程医疗方法 资助社区眼保健质量和可及性改善（平等） 这项研究使用了综合远程视神经评估（RONA）。 将采用对 EQUALITY 方法的修改，使用便携式测量 更适合农村的视觉功能和视神经、视网膜结构 我们还将确定并评估资源有限的地点。 针对患者坚持转诊和随访预约的障碍的策略 通过比较经济激励措施与经过验证的患者的有效性 教育计划与单独使用经过验证的患者教育计划。 FQHC 内的计划将能够在全国范围内扩展到农村和城市 服务不足的地点，因为这些中心在以下地区提供初级卫生保健服务 服务不足的地区，每年在 12,000 多个地点为超过 2700 万人提供治疗。