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协助青光眼患者及疑似患者进行协同护理的临床模型。

Clinical model assisting with the collaborative care of glaucoma patients and suspects.

作者信息

Jamous Khalid F, Kalloniatis Michael, Hennessy Michael P, Agar Ashish, Hayen Andrew, Zangerl Barbara

机构信息

Centre for Eye Health, UNSW Australia, Sydney, New South Wales, Australia.

School of Optometry and Vision Science, UNSW Australia, Sydney, New South Wales, Australia.

出版信息

Clin Exp Ophthalmol. 2015 May-Jun;43(4):308-19. doi: 10.1111/ceo.12466. Epub 2014 Nov 25.

Abstract

BACKGROUND

Optimizing patient management will reduce unnecessary vision loss in glaucoma through early detection. One method is the introduction of collaborative care schemes between optometrists and ophthalmologists.

DESIGN

We conducted a retrospective study to evaluate the impact of the Centre for Eye Health (CFEH) on glaucoma patient outcomes and management in primary optometric care.

PARTICIPANTS

Patients referred to CFEH by optometrists for a glaucoma assessment were eligible for this study if written consent was provided (500 participants were randomly chosen).

METHODS

Clinical data were classified according to disease risk and implemented patient care and analysed against the original diagnosis and patient parameters, followed by statistical analysis.

MAIN OUTCOME MEASURES

Two main parameters were evaluated; suitable referral of patients for glaucoma condition assessment and appropriate implementation of follow-up care.

RESULTS

The majority of patients referred for glaucoma assessment (86.2%) were classified as glaucoma suspects or likely to have glaucoma, indicating suitable referral of patients for a CFEH evaluation. Further, the involvement of CFEH resulted in a false positive rate of 7.8% for those patients who proceeded to ophthalmological care. However, long-term optometric patient care was not maintained for up to a third of primarily lower risk patients.

CONCLUSIONS

The investigated collaborative eye health-care model led to a substantial improvement in appropriate referrals of glaucoma patients to ophthalmologists and could be suitable for optimizing patient care and utilization of resources. Improvement in follow-up of patients by optometrists is required to minimize inappropriately discontinued patient care.

摘要

背景

通过早期检测优化患者管理将减少青光眼患者不必要的视力丧失。一种方法是引入验光师和眼科医生之间的协作护理方案。

设计

我们进行了一项回顾性研究,以评估眼健康中心(CFEH)对初级验光护理中青光眼患者治疗结果和管理的影响。

参与者

如果提供书面同意书,由验光师转介至CFEH进行青光眼评估的患者符合本研究条件(随机选择500名参与者)。

方法

临床数据根据疾病风险进行分类,并实施患者护理,然后对照原始诊断和患者参数进行分析,随后进行统计分析。

主要观察指标

评估两个主要参数;将患者适当地转介进行青光眼病情评估以及适当实施后续护理。

结果

大多数被转介进行青光眼评估的患者(86.2%)被归类为青光眼疑似患者或可能患有青光眼,这表明将患者适当地转介至CFEH进行评估。此外,CFEH的参与使那些接受眼科护理的患者的假阳性率为7.8%。然而,对于多达三分之一最初风险较低的患者,长期验光患者护理并未得到维持。

结论

所研究的协作性眼保健模式使青光眼患者向眼科医生的适当转诊率有了显著提高,并且可能适用于优化患者护理和资源利用。验光师需要改善对患者的随访,以尽量减少不适当中断的患者护理。

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