PURPOSE: Comparing the quality of care provided by a hospital-based shared care glaucoma follow-up unit with care as usual.
PATIENTS AND METHODS: This randomized controlled trial included stable glaucoma patients and patients at risk for developing glaucoma. Patients in the Usual Care group (n=410) were seen by glaucoma specialists. In the glaucoma follow-up unit group (n=405), patients visited the glaucoma follow-up unit twice followed by a visit to a glaucoma specialist. The main outcome measures were: compliance to the working protocol by glaucoma follow-up unit employees; difference in intraocular pressure between baseline and at ≥18 months; and patient satisfaction.
RESULTS: Glaucoma follow-up unit employees closely adhered to the working protocol for the measurement of intraocular pressure, visual acuity and GDx (≥97.5% of all visits). Humphrey Field Analyzer examinations were not performed as frequently as prescribed by the working protocol, but more often than in the Usual Care group. In a small minority of patients that required back-referral, the protocol was disregarded, notably when criteria were only slightly exceeded. There was no statistically significant difference in changes in intraocular pressure between the 2 treatment groups (P=0.854). Patients were slightly more satisfied with the glaucoma follow-up unit employees than with the glaucoma specialists (scores: 8.56 vs. 8.40; P=0.006).
CONCLUSIONS: In general, the hospital-based shared care glaucoma follow-up closely observed its working protocol and patients preferred it slightly over the usual care provided by medical doctors. The glaucoma follow-up unit operated satisfactorily and might serve as a model for shared care strategies elsewhere.
|Journal of Glaucoma
|Published - Apr 2016
- Intraocular Pressure/physiology
- Middle Aged
- Monitoring, Physiologic
- Ophthalmic Assistants/organization & administration
- Ophthalmology/organization & administration
- Optometry/organization & administration
- Patient Care Team/organization & administration
- Patient Satisfaction
- Patient-Centered Care
- Quality Assurance, Health Care
- Quality of Health Care/standards
- Tonometry, Ocular
- Visual Acuity