Time to Treatment Utilizing a Tele-Retinal Referral System for wAMD and DME: A Pilot Study

NCT01899963 | Completed

• 1 other identifier: Tele-retinal Referral T.T.T.
• Study Type: observational
• Target: 83
• Locations: 1 country
• Sites: 1

Brief Summary

In this province, optometrists are often responsible for contacting the retinal specialists' office to arrange patients to be examined for suspected emergencies or more routine referrals related to the eye. This is often done by faxing a referral form to the specialists' office, where the retinal specialist will examine the information presented in the referral form and make a decision on when the patient should be seen. This current method has some important considerations, such as the difficulty of transmitting clear images of the back of the eye over fax. Having this information could help the retinal specialist in determining when the patient should be seen, especially in terms of booking additional tests or when treatment should be given. Teleophthalmology is a branch of telemedicine that delivers eye care through digital equipment and telecommunications technology. It offers some unique advantages, such as the ability to be integrated with electronic health records, the ability to be viewed by multiple members of the health care team, and potentially reduce wait times and travel times to the ophthalmologist. However, there is no comparison known to the study team between whether patients being referred from optometrists to retina specialists through a teleophthalmology system will be treated earlier than patients through a conventional fax system. This study aims to examine and provide more information on this topic.

Conditions

Wet Age Related Macular Degeneration; Diabetic Macular Edema

Keywords

wet Age Related Macular Degeneration; Diabetic Macular Edema; Telemedicine; Teleophthalmology; Time to Treatment

Outcome Measures

Primary Outcomes (1)

• Time to Treatment

  Defined as defined as the time between when the retina specialist reviews the information collected by either system to when the patient receives treatment by the specialist in the clinic.

  Average 5-6 Weeks.

Secondary Outcomes (5)

• Maximum wait time

  Can range from 2-6 weeks.

• Minimum Wait Time

  Can range from 2-6 weeks.

• Mean wait time

  Can range from 2-6 weeks.

• Travel time

  Can range from 30 minutes or greater.

• Travel Distance

  Can range from 1 kilometer or greater.

Study Arms (2)

Tele-ophthalmology Referral Group

This group includes patients referred to a retinal specialist via a teleophthalmology referral system.

Conventional Referral Group

This group includes patients referred to a retinal specialist via a conventional fax system.

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

The study population includes patients who are referred from an optometrist either participating in the teleophthalmology referral system or via conventional fax referrals with a provisional diagnosis of possible wet AMD or DME to any of the physician investigators.

You may qualify if:

• Aged greater than 18 years,
• Able to provide informed consent,
• Referred from an optometrist either participating in the teleophthalmology referral system or via conventional fax referrals with a provisional diagnosis of possible wet AMD or DME to any of the physician investigators.

You may not qualify if:

• Patients with a presumed diagnosis of wet AMD and/or DME at the time of referral who previously had diagnostic imaging (ex. fundus images, OCT images) performed as part of the referral will be excluded;
• Patients unable to tolerate fluorescein angiography (FA);
• Patients unable to travel to the retina practice for treatment or further testing,
• Patients unable to fully understand the study requirements and provide informed consent.

Sponsors & Collaborators

• McMaster University: lead

Study Sites (1)

St. Joseph's Healthcare Hamilton King Campus

Hamilton, Ontario, L8G5E4, Canada

Location

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 9, 2013
• First Posted: July 16, 2013
• Study Start: November 1, 2013
• Primary Completion: January 1, 2022
• Study Completion: February 1, 2022
• Last Updated: May 22, 2023

Record last verified: 2023-05

Locations

CA (1)