Individuals aged ≥65 years, who attended the regional multidisciplinary low-vision clinic at the Royal Victoria Hospital, Belfast, and peripheral outreach clinics in Northern Ireland, were identified. They were sent information about the study, in large print, with a routine clinic appointment, and offered the information in audio format. At the clinic, the optometrist invited participation from those taking two or more different long-term oral medications daily, living within the community, not receiving daily medical or nursing care, and not participating in other research. For those who agreed, the optometrist recorded post refraction best corrected distance and near visual acuities (BCVA) using Bailey Lovie distance, and near-text reading charts.17 Visual impairment was defined by the World Health Organization (WHO) classification — BCVA <6/18 and >3/6018 — and those with BCVA outside these limits were excluded. Thus, all had some usable vision and were given optical aids, including spectacles.
How this fits in
Visual impairment is an increasing health problem, particularly among older people, and contributes to comorbidities that require long-term medication in primary care. Little is known about the impact of visual impairment on medication adherence or self-management. This study shows that almost 30% of older people with defined visual impairment need help in managing their medication, despite using optical aids; they are more than twice as likely as their peers without impaired vision to receive help from friends or statutory services. To ensure optimal health outcomes, clinicians must ask about problems with vision and check that appropriate support is available for individuals to take their medication as prescribed.
Primary care community optometrists recruited the control (C) group. They invited people aged ≥65 years to participate if they were taking two or more long-term oral medications daily, living in the same localities as those recruited with VI (to ensure availability of similar services), not requiring daily medical or nursing care and, had a BCVA of 6/9 or better. VA was measured using standardised optometry instrumentation and the same protocol as in the low-vision clinics. Anonymous data about those who declined to participate were recorded.
