Introducing e-health technology to routine cataract care: patient perspectives on web-based eye test for postoperative telemonitoring

Claessens, Janneau L. J.; Maats, Emma P E; Iacob, Maria-Eugenia; Wisse, Robert P. L.; Jongsma, Karin

doi:10.1097/j.jcrs.0000000000001189

Cited by 3 publications

(1 citation statement)

References 21 publications

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“…Interestingly, the instructions for the eye test itself were reported to be clear. This is in line with a recently published study on cataract patients (mean age 70, SD 7 years) [ 20 ]. In-depth interviews and quantitative questionnaires based on Technology Acceptance Models identified an overall positive attitude toward the web-based eye test.…”

Section: Discussionsupporting

confidence: 92%

The TeleTriageTeam, Offering Continuity of Personalized Care Through Telemedicine: Development and Evaluation

Claessens,

Mueller-Schotte,

van Weerden

et al. 2023

JMIR Hum Factors

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Background The COVID-19 pandemic taught us how to rethink care delivery. It catalyzed creative solutions to amplify the potential of personnel and facilities. This paper presents and evaluates a promptly introduced triaging solution that evolved into a tool to tackle the ever-growing waiting lists at an academic ophthalmology department, the TeleTriageTeam (TTT). A team of undergraduate optometry students, tutor optometrists, and ophthalmologists collaborate to maintain continuity of eye care. In this ongoing project, we combine innovative interprofessional task allocation, teaching, and remote care delivery. Objective In this paper, we described a novel approach, the TTT; reported its clinical effectiveness and impact on waiting lists; and discussed its transformation to a sustainable method for delivering remote eye care. Methods Real-world clinical data of all patients assessed by the TTT between April 16, 2020, and December 31, 2021, are covered in this paper. Business data on waiting lists and patient portal access were collected from the capacity management team and IT department of our hospital. Interim analyses were performed at different time points during the project, and this study presents a synthesis of these analyses. Results A total of 3658 cases were assessed by the TTT. For approximately half (1789/3658, 48.91%) of the assessed cases, an alternative to a conventional face-to-face consultation was found. The waiting lists that had built up during the first months of the pandemic diminished and have been stable since the end of 2020, even during periods of imposed lockdown restrictions and reduced capacity. Patient portal access decreased with age, and patients who were invited to perform a remote, web-based eye test at home were on average younger than patients who were not invited. Conclusions Our promptly introduced approach to remotely review cases and prioritize urgency has been successful in maintaining continuity of care and education throughout the pandemic and has evolved into a telemedicine service that is of great interest for future purposes, especially in the routine follow-up of patients with chronic diseases. TTT appears to be a potentially preferred practice in other clinics and medical specialties. The paradox is that judicious clinical decision-making based on remotely collected data is possible, only if we as caregivers are willing to change our routines and cognitions regarding face-to-face care delivery.

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Section: Discussionsupporting

confidence: 92%

The TeleTriageTeam, Offering Continuity of Personalized Care Through Telemedicine: Development and Evaluation

Claessens,

Mueller-Schotte,

van Weerden

et al. 2023

JMIR Hum Factors

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Web-based telemonitoring of visual function and self-reported postoperative outcomes in cataract care: international multicenter randomized controlled trial

Claessens,

Wanten,

Bauer

et al. 2024

J Cataract Refract Surg

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Purpose: Comparing web-based, self-administered follow-up after cataract surgery to conventional face-to-face follow-up. Setting: Eye clinics in the Netherlands, Austria and Germany. Design: Randomized controlled trial with an embedded method comparison study [ClinicalTrials.gov: NCT04809402]. Methods: Routine cataract patients were randomized into two groups: the 'telemonitoring' group undertook web-based vision self-assessments and questionnaires from home, while the 'usual care' group received conventional care. All participants had a 4-6 week post-surgery clinic visit for safety and validation purposes. Outcomes included: the web-test's accuracy for assessing postoperative visual acuity (VA) and refractive error; adverse event rates; and patient reported outcome measurements (PROMs). Results: 94 participants (188 eyes) were enrolled. Web-based uncorrected distance VA testing demonstrated a negligible mean difference (-0.03±0.14 logMAR) when compared to conventional ETDRS chart testing, with 95% limits-of-agreement ranging from -0.30 to 0.24 logMAR. The web-based refraction assessment overestimated the postoperative refractive error (mean difference 0.15±0.67 diopters), resulting in a poorer corrected distance VA compared to subjective refraction (mean 0.1 vs. -0.1 logMAR). Rates of adverse events and unscheduled consultations were minimal across both groups. Preoperative and postoperative PROMs questionnaires had a 100% response rate. Visual functioning (Catquest-9SF and NEI-VFQ-25) improved after surgery (mean improvement -0.80 and 16.70 respectively) and did not significantly differ between the two groups. Conclusion: The cataract patients in this study effectively provided postoperative outcome data via a web-interface. Both conventional and web-based follow-ups yielded similar PROMs and adverse event rates. Future developments should reduce the variability in the web-based VA test and yield representative refraction outcomes.

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Effect of sequential nursing care combined with communication intervention on visual recovery and pain after cataract ultrasound emulsification

Wang,

Zhang,

et al. 2024

World J Clin Cases

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BACKGROUND Cataracts are a common ophthalmic disease and postoperative vision recovery is crucial to patient quality of life. Rational and efficient care models play an important role in promoting vision recovery. AIM To evaluate the clinical effectiveness of procedural nursing care combined with communication intervention in vision recovery after cataract ultrasound emulsification. METHODS A randomized controlled study was conducted on 100 patients with cataracts who underwent ultrasound emulsification surgery. They were randomly assigned to an experimental group or a control group. The experimental group received procedural nursing combined with Connect, Introduce, Communicate, Ask, Respond, Exit (CICARE) communication intervention, whereas the control group received conventional nursing. The effectiveness of the nursing model was assessed by comparing differences in vision recovery, pain scores, and mental health status between the two groups. RESULTS It was found that over time the visual acuity of patients in both groups gradually recovered and patients in the experimental group had lower pain scores and superior mental health status than the control group (P < 0.05). CONCLUSION Procedural nursing combined with CICARE communication intervention has positive effects on vision recovery in patients after cataract ultrasound emulsification.

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Introducing e-health technology to routine cataract care: patient perspectives on web-based eye test for postoperative telemonitoring

Abstract: To explore cataract patients' experiences with an e-health tool for self-assessing visual function (ie, a web-based eye test), and to formulate recommendations for its successful adoption in routine cataract care.

Cited by 3 publications

References 21 publications

The TeleTriageTeam, Offering Continuity of Personalized Care Through Telemedicine: Development and Evaluation

The TeleTriageTeam, Offering Continuity of Personalized Care Through Telemedicine: Development and Evaluation

Web-based telemonitoring of visual function and self-reported postoperative outcomes in cataract care: international multicenter randomized controlled trial

Effect of sequential nursing care combined with communication intervention on visual recovery and pain after cataract ultrasound emulsification

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