Self-management of age-related macular degeneration at the 6-month follow-up: a randomized controlled trial

Arch Ophthalmol. 2005 Jan;123(1):46-53. doi: 10.1001/archopht.123.1.46.


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.

Conclusion: 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.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Affect / physiology
  • Aged
  • Aged, 80 and over
  • Depressive Disorder / prevention & control
  • Female
  • Follow-Up Studies
  • Health Education*
  • Humans
  • Macular Degeneration / psychology*
  • Macular Degeneration / therapy*
  • Male
  • Middle Aged
  • Problem Solving*
  • Psychological Tests
  • Quality of Life
  • Self Care / methods*
  • Sickness Impact Profile
  • Stress, Psychological / prevention & control
  • Surveys and Questionnaires
  • Waiting Lists