The Chronic Care for Age-Related Macular Degeneration Study and Quality of Life

A retinal photograph that shows advanced macular degeneration with a retinal bleed

As our readers know, I always like to look outside the United States for professional inspiration. This week, I read about a most interesting study/trial that is being conducted in Switzerland.

The Chronic Care for Age-Related Macular Degeneration Study (CHARMED) is an ongoing clinical trial that employs the Chronic Care Model as its primary intervention.

About the Chronic Care Model

The Chronic Care Model, first developed by the MacColl Institute for Healthcare Innovation, advocates for more productive interactions between the patient and his or her care team, which, in turn, can create a more effective and efficient patient-centered, health care model.

Key elements of the Chronic Care Model include patient empowerment; delivering evidence-based information; clinical information systems; establishing a reminder system with structured follow-up; and frequent monitoring via a specially trained Chronic Care Coach.

… all of which is near and near to my professional heart, especially the evidence-based information component.

About the CHARMED Study (from the study abstract)


Neovascular [i.e., wet] age-related macular degeneration is the leading cause of irreversible blindness in people 50 years of age or older in the developed world. As in other chronic diseases, several effective treatments are available, but in clinical daily practice there is an evidence/performance gap.

The Chronic Care Model represents an evidence-based framework for the care of chronically ill patients and aims at closing that gap.

Multiple studies have shown that implementing Chronic Care Model elements improves clinical outcomes … in different chronic diseases, such as osteoarthritis, depression, or cardiovascular risk in diabetes.

However, no data are available regarding patients with neovascular age-related macular degeneration (AMD). This study will be the first to assess this approach with patients with AMD.

Study Methods:

CHARMED is a multicenter randomized controlled trial involving 352 patients.

The study authors are investigating whether the implementation of core elements of the Chronic Care Model, via a specially trained Chronic Care Coach in Swiss centers for neovascular age-related macular degeneration, will result in better visual acuity (primary outcome) and an increased quality of life (secondary outcome) in patients with neovascular age-related macular degeneration.

Baseline measurements will be taken in months 3-8, starting in March 2011. Follow-up data will be collected after six months and one year.

If the study results confirm that the Chronic Care Model is an effective intervention, the implementation of this approach in routine care for patients with neovascular age-related macular degeneration should be considered.

VisionAware will provide updates on this important research as they become available.