title: Improved Adherence to Vision Self-monitoring with the Vision and Memory Stimulating (VMS) Journal for Non-neovascular Age-related Macular Degeneration during a Randomized Controlled Trial.
abstract: OBJECTIVE
  An educational, interactive journal [Vision and Memory Stimulating (VMS) journal] was developed to boost patient confidence and promote long-term adherence with weekly vision self-monitoring in age-related macular degeneration (AMD) patients at risk for vision loss from new-onset neovascularization.
  
  
  METHODS
  In a multicenter randomized controlled trial, 198 subjects with intermediate stage, non-neovascular AMD received the VMS journal or followed usual care (e.g. their doctor's instructions for vision monitoring; Amsler grid). At 6 and/or 12 months post-enrollment, 157 subjects completed a questionnaire on vision self-monitoring.
  
  
  RESULTS
  At 6 and 12 months, respectively, 85% and 80% of the VMS journal subjects reported vision monitoring at least weekly, which represent statistically significant 7.1 and 4.2 times greater odds than the 50% of controls who monitored weekly at both follow-up times (p<0.001). At 6 and 12 months, respectively, 29% and 25% of controls indicated that they had not checked their vision in the past 6 months, while only 1.5% and 5% of the VMS journal subjects reported no vision self-monitoring. At 6 and 12 months, respectively, only 15% and 13% of the VMS journal subjects vs. 53% and 44% of the controls reported that they did not feel confident that they were taking care of their sight by self-monitoring (p<0.001). Usual care controls had statistically significant 6.7 and 5.0 times greater odds of reporting non-confidence at 6 and 12 months, respectively. There was no statistically significant change in weekly vs. less frequent self-monitoring between the groups (p=0.68), with 81% of all subjects reporting no change in frequency between 6 and 12 months.
  
  
  CONCLUSIONS
  These findings support the efficacy of the VMS journal for increasing vision self-monitoring adherence and confidence, in addition to promoting persistence in weekly monitoring over the course of a year in AMD subjects at risk for exudative retinal changes.
authors.affiliation: Johns Hopkins Wilmer Eye Institute, 600 N. Wolfe St., Baltimore, MD 21287, USA ; Nova Southeastern University, College of Optometry, 3200 South University Dr., Ft. Lauderdale, FL, 33328-2018, USA.
authors.forename: Ava K
authors.initials: AK
authors.lastname: Bittner
authors.affiliation: KeepSight, 515 Old Slocum Rd, Hebron, CT 06248, USA.
authors.forename: Sheryl
authors.initials: S
authors.lastname: Torr-Brown
authors.affiliation: Johns Hopkins Wilmer Eye Institute, 600 N. Wolfe St., Baltimore, MD 21287, USA.
authors.forename: Ellen
authors.initials: E
authors.lastname: Arnold
authors.affiliation: Johns Hopkins Wilmer Eye Institute, 600 N. Wolfe St., Baltimore, MD 21287, USA.
authors.forename: Antonia
authors.initials: A
authors.lastname: Nwankwo
authors.affiliation: KeepSight, 515 Old Slocum Rd, Hebron, CT 06248, USA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Beaton
authors.affiliation: Moorefields Eye Hospital, London, UK.
authors.forename: Radhika
authors.initials: R
authors.lastname: Rampat
authors.affiliation: Johns Hopkins Wilmer Eye Institute, 600 N. Wolfe St., Baltimore, MD 21287, USA.
authors.forename: Gislin
authors.initials: G
authors.lastname: Dagnelie
authors.affiliation: KeepSight, 515 Old Slocum Rd, Hebron, CT 06248, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Roser
keywords: Adherence; Age-related macular degeneration; Amsler grid; Self-monitoring; Vision