1. Shared Care in Monitoring Stable Glaucoma Patients: A Randomized Controlled Trial.
- Author
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Holtzer-Goor KM, van Vliet EJ, van Sprundel E, Plochg T, Koopmanschap MA, Klazinga NS, and Lemij HG
- Subjects
- Aged, Female, Glaucoma physiopathology, Humans, Intraocular Pressure physiology, Male, Middle Aged, Monitoring, Physiologic, Ophthalmic Assistants organization & administration, Ophthalmic Assistants standards, Ophthalmology organization & administration, Ophthalmology standards, Optometry organization & administration, Optometry standards, Patient Satisfaction, Patient-Centered Care, Tonometry, Ocular, Visual Acuity, Glaucoma therapy, Patient Care Team organization & administration, Quality Assurance, Health Care, Quality of Health Care standards
- Abstract
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.
- Published
- 2016
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