Author: Kelvin Teo (Singapore)
Co-authors: Lucas Bachmann, Dawn Sim, Shu Yen Lee, Anna Tan, Chui Ming Gemmy Cheung, Gavin Tan
Purpose
We describe an experience of a large-scale self-initiated recruitment of patients to a self-monitoring initiative for macular pathology over the COVID-19 pandemic.
Setting/Venue
A total of 2272 patients from the Singapore National Eye Centre (SNEC) whose visits were rescheduled over lockdown (13 April to 1 June 2020) were offered participation in a self-monitoring initiative administered by SNEC with the Alleye application as the testing instrument.
Methods
This was an observational study with retrospective analysis. Demographics and characteristics were compared between those that signed up and those that did not. Similar comparisons were made between compliant patients versus those that were not. Outcomes were tracked for 6 months starting from the commencement of lockdown. Main outcome measures were participation and compliance rates. Patient characteristics that were more likely to participate and remain compliant.
Results
A total 732 (32%) patients participated in this self-monitoring initiative. Those who participated were younger (62 vs. 68 years, p<0·001), men, and living with family. Patients not on treatment, and those with poorer vision in their worse-seeing eye were more likely to participate. When grouped according to diagnosis, the proportion who participated was highest for diabetic macular edema (52%), non-neovascular age related macular degeneration (nAMD)(42%), diabetic retinopathy(35%), retinal vein occlusions(18%) , and nAMD(15%) (p<0·001). Testing compliance rate was 43% (315/732). Compliant patients were older, on treatment, and had poorer vision in the worse-seeing eye. Trigger events occurred in 33 patients with 5 patients having clinically verified disease progression (1·6%).
Conlusions
We provide real-world data on characteristics of patients with stable retinal diseases who were offered and participated in, and were compliant, with a self-monitoring program. The lower participation rate compared to standardized clinical studies reflects the difficulties in implementation for such initiatives in real-world settings. Despite this, self-monitoring continues to show promise in relieving clinic resources, suggesting the feasibility of scaling such programs beyond the COVID-19 pandemic.
Financial Disclosure
NA
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