Self-management of age-related macular degeneration at the 6-month follow-up: a randomized controlled trial.
OBJECTIVE
To assess the effectiveness at the 6-month follow-up of an age-related macular degeneration (AMD) self-management program consisting of health education and enhancement of problem-solving skills in improving quality of life as shown by measures of mood and function.


METHODS
Six-month follow-up data were analyzed from 214 of 252 older adult volunteers (mean age, 80.8 years) with advanced AMD who had been randomly assigned to a 12-hour self-management program (n = 82), a series of 12 hours of tape-recorded health lectures (n = 66), or a waiting list (n = 66). The primary outcome measure was emotional distress (Profile of Mood States). Secondary outcome measures included function (National Eye Institute Visual Function Questionnaire), self-confidence to handle AMD-specific challenges in daily life (AMD Self-efficacy Questionnaire), and depression status on the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition.


RESULTS
At the 6-month follow-up, participants in the self-management program reported significantly less emotional distress (P=.008), better function (P=.05), and increased self-efficacy (P=.006) compared with control subjects. The latter effects were more pronounced in the depressed than in the nondepressed subjects. Finally, the incidence of clinical depression at the 6-month follow-up was significantly lower in the self-management group (P=.05) than in the control group.


CONCLUSIONS
The sustained positive effects at the 6-month follow-up provide support for the effectiveness of the AMD self-management program in reducing distress and disability, improving self-efficacy, and preventing depression in poorly sighted elderly patients with AMD.
Brody
Barbara L
BL
Department of Ophthalmology, University of California, San Diego, La Jolla 92093-0946, USA.
Roch-Levecq
Anne-Catherine
AC
Thomas
Ronald G
RG
Kaplan
Robert M
RM
Brown
Stuart I
SI
D000339:Affect / Q000502:physiology; D000368:Aged; D000369:Aged, 80 and over; D003866:Depressive Disorder / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education; D006801:Humans; D008268:Macular Degeneration / Q000523:psychology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011340:Problem Solving; D011581:Psychological Tests; D011788:Quality of Life; D012648:Self Care / Q000379:methods*; D018434:Sickness Impact Profile; D013315:Stress, Psychological / Q000517:prevention & control; D011795:Surveys and Questionnaires; D014850:Waiting Lists