Alabama Screening and Intervention for Glaucoma and Eye Health through Telemedicine (AL-SIGHT): Baseline Results.
Owsley Cynthia, Swain Thomas A, McGwin Gerald, Nghiem Van Thi Ha, Register Shilpa, Asif Irfan M, Fazio Massimo, Antwi-Adjei Ellen K, Girkin Christopher A, Rhodes Lindsay A
AI Summary
Telemedicine screening in FQHCs detected high rates of treatable eye conditions (30% glaucoma, 37.6% cataract), with good follow-up attendance (76.7%) and high patient satisfaction, showing its effectiveness and scalability.
Abstract
Purpose
To describe baseline results of the Alabama Screening and Intervention for Glaucoma and Eye Health through Telemedicine (AL-SIGHT) for patients at federally qualified health centers (FQHCs). Candidates were persons at risk for glaucoma-associated diseases (GAD) based on age, race/ethnicity, current diagnosis of GAD, family history, and diabetes.
Design
Baseline screening visit followed by remote diagnosis and referral for follow-up examinations.
Methods
Patients presenting to FQHCs who were at least 18 years of age were enrolled and underwent screening for acuity, autorefraction, intraocular pressure, visual field testing, and fundus imaging. Results were transmitted to an ophthalmologist at University of Alabama at Birmingham for diagnosis who made referrals for follow-up; follow-up attendance was noted. Questionnaires assessed participants' perspectives on screening. Primary outcomes were rates of disease detection, referral for follow-up, follow-up attendance, and participant satisfaction.
Results
Of the 500 participants enrolled (mean age 58 years), 45.6% were African American and 51.6% White. Remote diagnostic evaluation of ocular screening by ophthalmologist revealed 30% GAD, 6.8% diabetic retinopathy, 37.6% cataract, 68.4% refractive error, 9.2% other eye conditions. In all, 47.2% of the participants were referred for follow-up examination and for acuity 20/40 or worse or IOP ≥23 mm Hg in one or both eyes. Follow-up examination attendance was 76.7% for those referred. Participants reported being very satisfied with screening (85.8%) and with the convenience of screening in their primary care clinic (92.2%).
Conclusions
The high percentage of patients diagnosed with treatable eye conditions at telemedicine screening suggest these programs in FQHCs can be effective and scalable nationwide. Attendance when referred for follow-up examination was high. Participants welcomed screenings in their communities.
MeSH Terms
Shields Classification
Key Concepts5
The Alabama Screening and Intervention for Glaucoma and Eye Health through Telemedicine (AL-SIGHT) program, conducted at federally qualified health centers (FQHCs), identified glaucoma-associated diseases (GAD) in 30% of 500 enrolled participants, diabetic retinopathy in 6.8%, cataract in 37.6%, refractive error in 68.4%, and other eye conditions in 9.2% through remote diagnostic evaluation of ocular screening by an ophthalmologist.
In the Alabama Screening and Intervention for Glaucoma and Eye Health through Telemedicine (AL-SIGHT) program, 47.2% of 500 participants were referred for follow-up examination due to acuity 20/40 or worse or intraocular pressure (IOP) ≥23 mm Hg in one or both eyes, with an attendance rate of 76.7% for those referred.
Participants in the Alabama Screening and Intervention for Glaucoma and Eye Health through Telemedicine (AL-SIGHT) program reported high satisfaction with screening, with 85.8% being very satisfied with the screening itself and 92.2% being very satisfied with the convenience of screening in their primary care clinic.
The Alabama Screening and Intervention for Glaucoma and Eye Health through Telemedicine (AL-SIGHT) program enrolled 500 participants with a mean age of 58 years, of whom 45.6% were African American and 51.6% were White.
The Alabama Screening and Intervention for Glaucoma and Eye Health through Telemedicine (AL-SIGHT) program enrolled patients at federally qualified health centers (FQHCs) who were at least 18 years of age and at risk for glaucoma-associated diseases (GAD) based on age, race/ethnicity, current diagnosis of GAD, family history, and diabetes.
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