Jones Lee, Konstantakopoulou Evgenia, Gazzard Gus
Moorfields Eye Hospital NHS Foundation Trust, London, UK.
Institute of Ophthalmology, University College London, London, UK.
BMJ Open Ophthalmol. 2020 May 25;5(1):e000438. doi: 10.1136/bmjophth-2020-000438. eCollection 2020.
In the UK, the National Institute for Health and Clinical Excellence are amending guidelines to support use of selective laser trabeculoplasty (SLT) as a first-line treatment for patients with glaucoma and ocular hypertension. The procedure is quick, effective in lowering intraocular pressure, cost-effective for the National Health Service and offers an equivalent safety profile to other therapies. The procedure is typically performed by an ophthalmologist; however, there is potential for suitably trained non-medical professionals to deliver the therapy. This scoping review will identify service delivery models where SLT is delivered by non-medical professionals worldwide, with a focus on optometrists.
A systematic search of the following databases will be conducted: CINAHL; MEDLINE Complete; Embase; HMIC and Ovid Emcare. For inclusion, studies must examine healthcare models of SLT delivery by optometrists and describe one of the following outcomes: training procedures; clinical effectiveness; safety and cost-effectiveness. A search of grey literature will be conducted via professional societies; national health departments; medicine regulatory bodies; charities and conference proceedings. Two reviewers will independently screen titles, abstracts and full-texts articles, followed by charting of data. This evidence synthesis will summarise findings narratively, supplemented with tables and descriptive statistics.
The review focuses on published articles and therefore ethical approval is not required. The findings will be relevant to key stakeholders including health service managers, policymakers, clinicians and patients. The findings of this review will be disseminated through peer-reviewed publications, conference presentations and summary reports for key stakeholders.
在英国，国家卫生与临床优化研究所正在修订指南，以支持将选择性激光小梁成形术（SLT）作为青光眼和高眼压症患者的一线治疗方法。该手术操作迅速，能有效降低眼压，对国民医疗服务体系而言具有成本效益，并且与其他疗法具有同等的安全性。该手术通常由眼科医生进行；然而，经过适当培训的非医学专业人员也有提供这种治疗的可能性。本范围综述将确定全球范围内由非医学专业人员（重点是验光师）提供SLT治疗的服务提供模式。
将对以下数据库进行系统检索：护理学与健康领域数据库（CINAHL）；医学期刊数据库（MEDLINE Complete）；荷兰医学文摘数据库（Embase）；英国医学期刊数据库（HMIC）和Ovid Emcare。纳入的研究必须考察验光师提供SLT治疗的医疗模式，并描述以下结果之一：培训程序；临床疗效；安全性和成本效益。将通过专业协会、国家卫生部门、药品监管机构、慈善机构和会议论文集检索灰色文献。两名评审员将独立筛选标题、摘要和全文文章，随后进行数据图表制作。本证据综合将以叙述方式总结研究结果，并辅以表格和描述性统计数据。
本综述聚焦于已发表的文章，因此无需伦理批准。研究结果将与包括卫生服务管理人员、政策制定者、临床医生和患者在内的关键利益相关者相关。本综述的研究结果将通过同行评审出版物、会议报告以及为关键利益相关者撰写的总结报告进行传播。
