Glaucoma Community Care: Does Ongoing Shared Care Work?

Angelica Ly; Elizabeth Wong; Jessie Huang; Michael Yapp; Katherine Masselos; Michael Hennessy; Michael Kalloniatis; Barbara Zangerl

doi:10.5334/ijic.5470

Glaucoma Community Care: Does Ongoing Shared Care Work?

Int J Integr Care. 2020 Aug 7;20(3):5. doi: 10.5334/ijic.5470.

Authors

Angelica Ly^{1

2}, Elizabeth Wong^{1

2}, Jessie Huang^{1

2}, Michael Yapp^{1

2}, Katherine Masselos^{1

3}, Michael Hennessy^{1

3}, Michael Kalloniatis^{1

2}, Barbara Zangerl^{1

2}

Affiliations

¹ Centre for Eye Health, Sydney, NSW, AU.
² School of Optometry and Vision Science, UNSW Sydney, Sydney, NSW, AU.
³ Department of Ophthalmology, Prince of Wales Hospital, Sydney, NSW, AU.

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.

Keywords: chronic eye disease; collaborative care; task-shifting; telemedicine.

Grants and funding

This work was supported by the National Health and Medical Research Council grant number 1033224 and Guide Dogs NSW/ACT.