Randomised controlled trial of an integrated versus an optometric low vision rehabilitation service for patients with age-related macular degeneration: study design and methodology

A number of studies have measured the outcomes of low vision care but these have usually been longitudinal case series, thus constituting very low qua lity of evidence for effectiveness. To date, there have been no randomised controlled trials (RCTs) which have evaluated the effectiveness and cost ef fectiveness of different models of care in low vision. The size of the low vision population and the paucity of systematic evaluation have created a p ressing need for evidence about cost-effectiveness in order to inform servi ce developments for low vision rehabilitation. This paper describes the stu dy design and methodology of a three-arm RCT currently under way in Manches ter. The baseline population recruited is also described. A traditional hos pital-based optometric service is being compared with an integrated service (comprising the addition of community-based rehabilitation officer input) and with more generic community input (which is non-integrated and is not v ision specific). A wide range of outcome measures are being assessed at rec ruitment and 12 months post-intervention, including low vision specific and generic quality of life measures, patterns of low vision aid use, and task performance. The rationale for the trial is discussed and the main study o utcomes are described. (C) 2000 The College of Optometrists, Published by E lsevier Science Ltd. All rights reserved.