Roberts Harry W, Rughani Keshma, Syam Padmanhaba, Dhingra Sumit, Ramirez-Florez Susanna
Eye Department, Peterborough and Stamford NHS Foundation Trust , Peterborough , UK and.
Curr Eye Res. 2015 Jul;40(7):690-6. doi: 10.3109/02713683.2014.957326. Epub 2014 Oct 13.
To report on results of an innovative glaucoma shared-care scheme based in Peterborough, UK.
A retrospective review of all new appointments with 11 community-based specialist optometrists in glaucoma (SOG) was conducted. There are two tiers of SOG, whereby tier 2 SOGs have increased levels of autonomy. All optometrist assessments were reviewed by a consultant ophthalmologist, and levels of agreement were calculated for assessment of optic nerve head appearance, Humphrey visual field test interpretation, diagnosis and outcome.
1639 new patients were assessed by SOGs over a 4-year period. The median waiting time for patients from referral to SOG assessment was 0 days (IQR 0-56), and from SOG assessment to consultant review in a virtual clinic was 12 days (IQR 8-18days). After first appointment, over 60% of patients were classified as low-risk and remained within the SOG scheme. Rates of frank disagreement between SOG and consultant regarding diagnosis and proposed outcome were 5.6 and 10.4%, respectively, for tier 2 SOGs and 15.3 and 28.6%, respectively, for tier 1 SOGs.
The SOG scheme demonstrates acceptable levels of accuracy between SOG and glaucoma consultant. This scheme allows many stable low-risk patients to remain out of hospital eye department outpatient clinics.
报告英国彼得伯勒一项创新型青光眼共享护理计划的结果。
对11名社区青光眼专科验光师（SOG）的所有新预约患者进行回顾性研究。SOG分为两级，其中二级SOG的自主权更高。所有验光师的评估均由眼科顾问医生进行审核，并计算视神经乳头外观评估、汉弗莱视野测试解读、诊断及结果的一致性水平。
4年间，SOG共评估了1639名新患者。患者从转诊至SOG评估的中位等待时间为0天（四分位间距0 - 56天），从SOG评估至虚拟诊所的顾问复查的中位等待时间为12天（四分位间距8 - 18天）。首次就诊后，超过60%的患者被归类为低风险，并仍留在SOG计划中。二级SOG和一级SOG在诊断和建议结果方面，SOG与顾问之间的明显分歧率分别为5.6%和10.4%，以及15.3%和28.6%。
SOG计划显示出SOG与青光眼顾问之间可接受的准确性水平。该计划使许多病情稳定的低风险患者无需前往医院眼科门诊就诊。
