Abstract
Purpose:We assessed a novel, public, vertical integrated care model for glaucoma management in the community.Methods:This study was a retrospective, longitudinal study of 266 patients diagnosed or suspected of glaucoma. Patients were stratified to either ongoing ophthalmology-led (n = 81) or optometry-led shared care (n = 185). Demographics and clinical characteristics, including the re-referral rate and timeliness of follow up were analysed.Results:Just under half (565/1224, 46%) of all follow up consultations over the total study period of 45 months were seen in optometry-led care, with a re-referral rate to ophthalmology of 21%. Treated patients showed a median intraocular pressure reduction of 20% and a median time delay of just two days between the actual and recommended review period.Conclusions:Shared care provides an effective option for managing the ongoing care burden in chronic stable glaucoma cases at low risk of vision loss.
Highlights
Glaucoma is a progressive optic neuropathy and a leading cause of vision impairment worldwide that requires lifelong surveillance and management [1]
We described the value of optometryophthalmology shared care in referral refinement [20] and the baseline characteristics of patients entering into a hybrid care model [10]
We describe the activity and effectiveness of a protocol-based, virtual review-facilitated, glaucoma vertical integrated care model operating in Sydney, Australia using care outcomes including intraocular pressure, progression in visual fields mean deviation, and adherence to follow up
Summary
Glaucoma is a progressive optic neuropathy and a leading cause of vision impairment worldwide that requires lifelong surveillance and management [1]. In Australia, there are only 990 qualified ophthalmologists to meet the demand and only 16 per cent are employed in the public sector [4]. These ophthalmology workforce numbers are not expected to grow in line with the expansion of the aged population [5], which has led to a growing global interest in glaucoma shared care models [1, 6,7,8,9,10,11,12,13].
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