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Lima Ramos, Pedro
Publications (7 of 7) Show all publications
Hernández-Moreno, L., Senra, H., Lewis, P., Moreno, N., Linhares, J., Santana, R., . . . Macedo, A. F. (2020). Cost‐effectiveness of basic vision rehabilitation (The basic VRS‐effect study): study protocol for a randomised controlled trial. Paper presented at 2020/01/28. Ophthalmic & physiological optics
Open this publication in new window or tab >>Cost‐effectiveness of basic vision rehabilitation (The basic VRS‐effect study): study protocol for a randomised controlled trial
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2020 (English)In: Ophthalmic & physiological optics, ISSN 0275-5408, E-ISSN 1475-1313Article in journal (Refereed) Epub ahead of print
Abstract [en]

Abstract Purpose To investigate the cost-effectiveness of a basic vision rehabilitation service (basic-VRS) in Portugal. We designed a parallel group, randomised controlled trial whose aim is to compare the effects and costs of ?usual low vision care? with a ?basic-VRS intervention? on self-reported visual ability and other psychosocial and health-related quality-of-life outcomes. Methods The trial will recruit participants that meet the following inclusion criteria: (1) visual acuity between 0.4?1.0 logMAR in the better-seeing eye, (2) cause of vision loss is diabetic retinopathy or age-related macular degeneration, (3) 18 years or older and iv) live in the community (not in nursing homes or other type of institution). Participants will be randomised to one of the study arms consisting of immediate intervention and delayed intervention. The delayed intervention group will receive ?usual care? or no intervention in the first 12 weeks. Visual acuity, contrast sensitivity and retinal structure will be assessed during the study. Results The primary outcome measure is visual ability, which will be evaluated with the Massof Activity Inventory, we expect that the intervention will raise the overall person measure or visual ability. Reading, health-related quality-of-life, anxiety and depression and social support will be also assessed. The analysis will be undertaken on an intention-to-treat basis. A cost-effectiveness analysis will be performed to provide information about the cost per unit of utility. To evaluate the cost-effectiveness of the intervention we will adopt the perspective of the healthcare system. Conclusion This study will provide additional evidence about the effects of basic-VRS on self-reported visual ability. Findings from this study should also contribute to better planning of low vision provision and, consequently, may contribute to reduce barriers to basic-VRS.

Place, publisher, year, edition, pages
John Wiley & Sons, 2020
Keywords
cost-effectiveness, magnification, quality-of-life, vision impairment, vision rehabilitation, visual ability
National Category
Ophthalmology
Research subject
Natural Science, Optometry
Identifiers
urn:nbn:se:lnu:diva-91382 (URN)10.1111/opo.12665 (DOI)000509491000001 ()31989690 (PubMedID)
Conference
2020/01/28
Available from: 2020-01-28 Created: 2020-01-28 Last updated: 2020-02-21
Marques, A. P., Macedo, A. F., Lima Ramos, P., Moreno, L. H., Butt, T., Rubin, G. & Santana, R. S. (2019). Productivity Losses and Their Explanatory Factors Amongst People with Impaired Vision. Ophthalmic Epidemiology, 26(6), 378-392
Open this publication in new window or tab >>Productivity Losses and Their Explanatory Factors Amongst People with Impaired Vision
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2019 (English)In: Ophthalmic Epidemiology, ISSN 0928-6586, E-ISSN 1744-5086, Vol. 26, no 6, p. 378-392Article in journal (Refereed) Published
Abstract [en]

Purpose: To estimate productivity losses amongst people with impaired vision in Portugal and to investigate explanatory factors associated with non-participation in the labour market.

Methods: A total of 546 visually impaired individuals participated in face-to-face interviews. Participants were asked about their workforce participation to determine productivity (employment status questionnaire), their health-related quality of life – HRQoL (EQ-5D) and their visual acuity and visual ability (Activity Inventory). Productivity losses included absenteeism and reduction in workforce participation. Logistic regression was used to determine independent factors associated with participation in the labour market.

Results: From the 546 participants, 50% were retired, 47% were of working age and 3% were students. The employment rate was 28%, and the unemployment rate was 21% for the working age sample. For those of working age, productivity losses were estimated at €1.51 million per year, mean of €5496 per participant. The largest contributor to productivity losses was reduced workforce participation, estimated from 159 early retired or unemployed participants. After controlling for visual acuity and ability, younger individuals, with more years of education, without comorbidities and high HRQoL had a higher probability of being employed.

Conclusions: Our findings show a high unemployment rate and high productivity losses amongst people with impaired vision. The probability of being employed was associated with education, HRQoL and comorbidities. We speculate that promoting education and health through effective visual rehabilitation programs may help to increase participation in the labour market. These findings can inform decisions to intervene to reduce the burden of vision loss.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2019
Keywords
Vision Impairment, productivity losses, patient reported outcomes measures, employment, HRQoL
National Category
Public Health, Global Health, Social Medicine and Epidemiology Ophthalmology
Research subject
Natural Science, Optometry
Identifiers
urn:nbn:se:lnu:diva-86286 (URN)10.1080/09286586.2019.1632904 (DOI)000474689700001 ()31280630 (PubMedID)
Available from: 2019-07-10 Created: 2019-07-10 Last updated: 2020-03-11Bibliographically approved
Lima Ramos, P., Santana, R., Moreno, L. H., Marques, A. P., Freitas, C., Rocha-Sousa, A., . . . ., T. P. (2018). Predicting participation of people with impaired vision in epidemiological studies. BMC Ophthalmology, 18, Article ID 236.
Open this publication in new window or tab >>Predicting participation of people with impaired vision in epidemiological studies
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2018 (English)In: BMC Ophthalmology, ISSN 1471-2415, E-ISSN 1471-2415, Vol. 18, article id 236Article in journal (Refereed) Published
Abstract [en]

Background

The characteristics of the target group and the design of an epidemiologic study, in particular the recruiting methods, can influence participation. People with vision impairment have unique characteristics because those invited are often elderly and totally or partially dependent on help to complete daily activities such as travelling to study sites. Therefore, participation of people with impaired vision in studies is less predictable than predicting participation for the general population.

Methods

Participants were recruited in the context of a study of prevalence and costs of visual impairment in Portugal (PCVIP-study). Participants were recruited from 4 Portuguese public hospitals. Inclusion criteria were: acuity in the better eye from 0.5 decimal (0.30logMAR) or worse and/or visual field of less than 20 degrees. Recruitment involved sending invitation letters and follow-up phone calls. A multiple logistic regression model was used to assess determinants of participation. The J48 classifier, chi-square and Fisher’s exact tests were applied to investigate the possible differences between subjects in our sample.

Results

Individual cases were divided into 3 groups: immediate, late and non-participants. A participation rate of 20% was obtained (15% immediate, 5% late). Factors positively associated with participation included years of education, annual hospital attendance, and intermediate visual acuity. Females and greater distance to the hospital were inversely associated with participation.

Conclusion

In our study, a letter followed by a phone call was efficient to recruit a significant number of participants from a larger group of people with impaired vision. However, the improvement in participation observed after the phone call might not be cost-effective. People with low levels of education and women were more difficult to recruit. These findings need to be considered to avoid studies whose results are biased by gender or socio-economic inequalities of their participants. Young subjects and those at intermediate stages of vision impairment, or equivalent conditions, may need more persuasion than other profiles.

Place, publisher, year, edition, pages
BioMed Central, 2018
Keywords
Study participation; Epidemiologic studies; Study design; Vision impairment; Recruitment strategies
National Category
Ophthalmology Other Medical Sciences not elsewhere specified
Research subject
Natural Science, Optometry; Natural Science, Medicine; Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-77576 (URN)10.1186/s12886-018-0889-9 (DOI)000443738400002 ()30180834 (PubMedID)2-s2.0-85053144738 (Scopus ID)
Projects
This study was supported by FCT (COMPETE/QREN) grant reference PTDC/DPT-EPI/0412/2012 in the context of the Prevalence and Costs of Visual Impairment in Portugal: a hospital based study (PCVIP-study). PLR is funded by FCT (COMPETE/QREN) grant reference SFRH/BD/119420/2016.
Available from: 2018-09-05 Created: 2018-09-05 Last updated: 2019-08-29Bibliographically approved
Lima Ramos, P., Santana, R., Sousa, I., Rocha-Sousa, A. A. & Macedo, A. F. (2018). Prevalence of Visual Impairment in the Municipality of Braga -Portugal using capture-recapture methods. Paper presented at Annual Meeting of the Association-for-Research-in-Vision-and-Ophthalmology (ARVO), APR 29-MAY 03, 2018, Honolulu, HI. Investigative Ophthalmology and Visual Science, 59(9)
Open this publication in new window or tab >>Prevalence of Visual Impairment in the Municipality of Braga -Portugal using capture-recapture methods
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2018 (English)In: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 59, no 9Article in journal, Meeting abstract (Other academic) Published
National Category
Ophthalmology
Research subject
Natural Science, Optometry
Identifiers
urn:nbn:se:lnu:diva-78107 (URN)000442912503007 ()
Conference
Annual Meeting of the Association-for-Research-in-Vision-and-Ophthalmology (ARVO), APR 29-MAY 03, 2018, Honolulu, HI
Available from: 2018-10-01 Created: 2018-10-01 Last updated: 2018-10-01Bibliographically approved
Marques, A. P., Macedo, A. F., Hernandez-Moreno, L., Lima Ramos, P., Butt, T., Rubin, G. & Santana, R. (2018). The use of informal care by people with vision impairment. PLoS ONE, 13(6), Article ID e0198631.
Open this publication in new window or tab >>The use of informal care by people with vision impairment
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2018 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 6, article id e0198631Article in journal (Refereed) Published
Abstract [en]

Purpose

To estimate and characterize the use of informal care by people with vision impairment in Portugal.

Methods

A total of 546 visually impaired individuals were recruited from Portuguese hospitals. Clinical information was obtained from medical records, socio-demographic details and informal care use were collected during face-to-face interviews. In addition, participants responded to a functional vision questionnaire (activity inventory) to assess their visual ability. Logistic regression was used to determine independent factors associated with informal care use and linear regression was used to determine independent predictors of intensity of informal care use.

Results

Informal care was reported by 39.6% of the participants. The probability of reporting informal care was higher in non-married, those with comorbidities, with lower visual ability and worse visual acuity. The median number of caregivers’ hours per year was 390 (mean = 470; 95%CI = 488–407), which represent a median opportunity cost of €2,586. Visual ability was the only independent predictor of number of hours of informal care received.

Conclusions

Informal care was frequently used by individuals with impaired vision. Improving visual ability of people with impaired vision when performing valued activities may reduce the burden of visual loss at personal and societal level. This could be achieved with person-centred visual rehabilitation.

Place, publisher, year, edition, pages
Public Library of Science, 2018
National Category
Other Health Sciences
Research subject
Natural Science, Optometry; Natural Science, Medicine
Identifiers
urn:nbn:se:lnu:diva-75353 (URN)10.1371/journal.pone.0198631 (DOI)000434384900063 ()29879193 (PubMedID)2-s2.0-85048155166 (Scopus ID)
Available from: 2018-06-07 Created: 2018-06-07 Last updated: 2019-08-29Bibliographically approved
Moreno, L. H., Perdomo, N. M., Lima Ramos, P., Lewis, P., Linhares, J., Senra, H., . . . Macedo, A. F. (2018). Visual and psychological outcomes in patients with and without low vision diagnosed with similar eye diseases - initial results.. Paper presented at Annual Meeting of the Association-for-Research-in-Vision-and-Ophthalmology (ARVO), APR 29-MAY 03, 2018, Honolulu, HI. Investigative Ophthalmology and Visual Science, 59(9)
Open this publication in new window or tab >>Visual and psychological outcomes in patients with and without low vision diagnosed with similar eye diseases - initial results.
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2018 (English)In: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 59, no 9Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
ASSOC RESEARCH VISION OPHTHALMOLOGY INC, 2018
National Category
Ophthalmology
Research subject
Natural Science, Optometry
Identifiers
urn:nbn:se:lnu:diva-78426 (URN)000442932800279 ()
Conference
Annual Meeting of the Association-for-Research-in-Vision-and-Ophthalmology (ARVO), APR 29-MAY 03, 2018, Honolulu, HI
Available from: 2018-10-22 Created: 2018-10-22 Last updated: 2018-10-22Bibliographically approved
Macedo, A. F., Lima Ramos, P., Hernandez-Moreno, L., Cima, J., Baptista, A. M. G., Marques, A. P., . . . Santana, R. (2017). Visual and health outcomes, measured with the activity inventory and the EQ-5D, in visual impairment. Acta Ophthalmologica, 95(8), e783-e791
Open this publication in new window or tab >>Visual and health outcomes, measured with the activity inventory and the EQ-5D, in visual impairment
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2017 (English)In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 95, no 8, p. e783-e791Article in journal (Refereed) Published
Abstract [en]

Purpose

Generic instruments to assess health utilities can be used to express the burden of health problems in widely used indexes. That is in contrast with what can be obtained with condition-specific instruments, outcomes are very specific and difficult to compare across conditions. The purpose of this study was to assess health and visual outcomes and its determinants in patients with visual impairment (VI) using the EQ-5D-3L and the Activity Inventory (AI).

Methods

Participants were recruited in different hospitals during the PCVIP-study. A total of 134 patients with acuity 0.30 logMAR or less in the better eye were interviewed. The AI includes 46 goals split between three objectives: social functioning, recreation and daily living, and was used to measure visual ability. The EQ-5D consists of five questions covering one domain each and was used to provide a measure of health states. Responses to each domain were combined to produce a single individual index.

Results

The AI and the EQ-5D-3L showed enough discriminatory power between VI levels (p < 0.001), and their results were strongly correlated r(134) = 0.825, (p < 0.001). Explanatory factors for visual ability were level of VI in better eye, age and gender, R2 = 0.43, (p < 0.001). Explanatory factors for the EQ-5D-3L were level of VI in the better eye, comorbidities and gender, R2 = 0.36, (p < 0.001).

Conclusion

Our results showed that the EQ-5D-3L is useful when characterizing the burden of VI and to compute, when necessary, quality-adjusted-life-years (QALY) changes due to VI. However, it is important to consider that the EQ-5D-3L uses a coarse response scale, assesses a limited spectrum of domains and is influenced by comorbidities. This might limit its responsiveness to small changes in visual ability.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2017
National Category
Ophthalmology Other Medical Sciences not elsewhere specified
Research subject
Natural Science, Optometry
Identifiers
urn:nbn:se:lnu:diva-62158 (URN)10.1111/aos.13430 (DOI)000417645900021 ()28371261 (PubMedID)2-s2.0-85016721679 (Scopus ID)
Projects
Prevalence and Costs of Visual Impairment in Portugal
Note

FCT. Grant Number: PTDC/DPT-EPI/0412/2012

Available from: 2017-04-09 Created: 2017-04-09 Last updated: 2019-08-29Bibliographically approved
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