Cost-Effectiveness Of The Core-Rct: Web-Based Telemonitoring Of Visual Function In Cataract Care
Published 2024 - 42nd Congress of the ESCRS
Reference: FP26.12 | Type: Free paper | DOI: 10.82333/pf4f-1h24
Authors: Casper Van Der Zee* 1 , Janneau Claessens 1 , Nicolaas Reus 2 , Violette Vrijman 3 , Karl Boden 4 , Oliver Findl 5 , Rudy Nuijts 6 , Saskia Imhof 1 , Miriam van der Meulen 7 , Robert Wisse 8
1Ophthalmology,UMC Utrecht,Utrecht ,Netherlands, 2Ophthalmology,Amphia Hospital,Breda,Netherlands, 3Oogcentrum Noord-Holland,Heerhugowaard,Netherlands, 4Ophthalmology,Knappschaft Hospital Saar,Sulzbach,Germany, 5Institute for Research in Ocular Surgery,Karl Landsteiner Institute, Hanusch Hospital,Vienna,Austria, 6Ophthalmology,Maastricht UMC,Maastricht,Netherlands, 7Epidemiology and Health Economics,Julius Center UMC Utrecht,Utrecht ,Netherlands, 8Ophthalmology,UMC Utrecht,Utrecht ,Netherlands;Easee BV,Amsterdam,Netherlands
Purpose
To report on the potential cost-savings of remote digital follow up after cataract surgery; a health economic evaluation of the prospective international CORE trial
Setting
A randomized controlled design assessing six eye clinics in the Netherlands, Austria and Germany [ClinicalTrials.gov: NCT04809402].
Methods
Routine cataract patients were randomized into two groups: the 'telemonitoring' group undertook web-based vision self-assessments of visual acuity, refractive error and a symptom checker with questionnaires from home, while the 'usual care' group received conventional care, on-site. Here we report on care consumption in relation to clinical- and patient reported outcome measurements, health-related and vision-related quality of life, and costing questionnaires. The costs were analyzed from a health care perspective.
Results
94 participants (188 eyes) were enrolled. Web-based uncorrected distance VA testing demonstrated a good agreement with conventional ETDRS chart testing, with a negligible mean difference (-0.03±0.14 logMAR). Vision-related quality of life improved after surgery, yet did not significantly differ between the two groups. Preoperative and postoperative PROMs questionnaires had a 100% response rate, and did not yield materially different results. Rates of adverse events were minimal across both groups, whilst the telemonitoring group had lower rates of unscheduled clinical contact (both teleconsultations and on-site consultations).
Conclusions
Remote digital care after cataract surgery yielded similar clinical outcomes, qualities of life, and adverse event rates as conventional care. A full report on the health economic impact will be presented. The home-performed vision self-assessment has the potential to reduce costs and patient burden in the cataract patient pathway in a health care perspective since it reduces physical clinical visits, whilst not increasing adverse event.