Project Details
Project Name
Digital technologies for home monitoring glaucoma: a feasibility study
Description / Abstract
"Glaucoma is a common chronic eye condition and the second commonest cause of blindness in the UK. It is typically caused by the pressure in the eye (intraocular pressure) being too high, Glaucoma impairs mainly the peripheral vision (visual field). Treatments reduce eye pressure to delay or stop glaucoma getting worse. However, in some glaucoma may still progress, so patients need regular monitoring at hospital eye services where they have their eye pressure and the visual field measured. This allows doctors to assess effectiveness of current treatment and detect glaucoma progression. Patients need these check-ups for the rest of their lives.
Hospital eye services are very busy, accounting for 10% of all NHS outpatient visits. Glaucoma patients represent a significant part of this workload, England alone over 1 million visits per year are for glaucoma patients. Providing regular surveillance and treatment is already a major challenge for the NHS. The chance of getting glaucoma increases with age. Demand for glaucoma care is increasing (and will continue to do so) due to our aging population.
Recent advances in technology mean it is now possible for glaucoma patients to monitor eye pressure and visual fields in their own home. Their information could be transferred to the hospital, or they could request hospital appointment if the home tests show their glaucoma has worsened or eye pressure has increased. Home monitoring could mean patients requiring fewer hospital check-ups, whilst increasing convenience and potentially reducing costs and increase capacity for the NHS.
Currently though, we do not know if home monitoring is acceptable to people with glaucoma, or if home monitoring in the general glaucoma population is feasible. The main aim of our study is assess acceptability and feasibility of home monitoring, and to make recommendations about future research to test how the NHS could use home monitoring.
In our project, 45 patients with glaucoma from (15 each from Northern Ireland, Scotland and England) will get home monitoring equipment and an iPad tablet and a home tonometer to do home monitoring tests weekly for 4 months. We'll train patients to perform the tests and offer refresher training throughout the study. We'll also interview patients and their carers about their experiences of performing the tests, focusing on the difficulties experienced and what could be done to make the home tests more acceptable.
We have chosen a visual field test and eye pressure test that previous research has shown is suitable for home monitoring use. The visual field tests display lights or patterns on an iPad tablet and patients indicate by entering information on the touch screen whenever they see the light. The iCare HOME tonometer is a device designed to check the eye pressure at home. The information from both of these tests will automatically be transferred to our research team for analysis.
This research fits one of the top 5 research recommendations by the James Lind Alliance, i.e., What can be done to improve early diagnosis of sight-threatening glaucoma? We have included two patients as independent members of the Study Steering Committee who will be actively involved in the conduct and governance of the research. We will also involve the International Glaucoma Society in an advisory role. Results of the study will be shared with those who participated and with relevant stakeholders in Hospital Eye Services."
Hospital eye services are very busy, accounting for 10% of all NHS outpatient visits. Glaucoma patients represent a significant part of this workload, England alone over 1 million visits per year are for glaucoma patients. Providing regular surveillance and treatment is already a major challenge for the NHS. The chance of getting glaucoma increases with age. Demand for glaucoma care is increasing (and will continue to do so) due to our aging population.
Recent advances in technology mean it is now possible for glaucoma patients to monitor eye pressure and visual fields in their own home. Their information could be transferred to the hospital, or they could request hospital appointment if the home tests show their glaucoma has worsened or eye pressure has increased. Home monitoring could mean patients requiring fewer hospital check-ups, whilst increasing convenience and potentially reducing costs and increase capacity for the NHS.
Currently though, we do not know if home monitoring is acceptable to people with glaucoma, or if home monitoring in the general glaucoma population is feasible. The main aim of our study is assess acceptability and feasibility of home monitoring, and to make recommendations about future research to test how the NHS could use home monitoring.
In our project, 45 patients with glaucoma from (15 each from Northern Ireland, Scotland and England) will get home monitoring equipment and an iPad tablet and a home tonometer to do home monitoring tests weekly for 4 months. We'll train patients to perform the tests and offer refresher training throughout the study. We'll also interview patients and their carers about their experiences of performing the tests, focusing on the difficulties experienced and what could be done to make the home tests more acceptable.
We have chosen a visual field test and eye pressure test that previous research has shown is suitable for home monitoring use. The visual field tests display lights or patterns on an iPad tablet and patients indicate by entering information on the touch screen whenever they see the light. The iCare HOME tonometer is a device designed to check the eye pressure at home. The information from both of these tests will automatically be transferred to our research team for analysis.
This research fits one of the top 5 research recommendations by the James Lind Alliance, i.e., What can be done to improve early diagnosis of sight-threatening glaucoma? We have included two patients as independent members of the Study Steering Committee who will be actively involved in the conduct and governance of the research. We will also involve the International Glaucoma Society in an advisory role. Results of the study will be shared with those who participated and with relevant stakeholders in Hospital Eye Services."
| Status | Finished |
|---|---|
| Effective start/end date | 1/01/21 → 31/12/22 |
| Links | http://fundingawards.nihr.ac.uk/award/NIHR129248 |