Simons Anne-Sophie, Vercauteren Julie, Barbosa-Breda João, Stalmans Ingeborg
Department of Ophthalmology, University Hospitals Leuven, 3000 Leuven, Belgium.
Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium.
J Clin Med. 2021 Oct 19;10(20):4785. doi: 10.3390/jcm10204785.
Glaucoma patients require lifelong management, and the prevalence of glaucoma is expected to increase, resulting in capacity problems in many hospital eye departments. New models of care delivery are needed to offer requisite capacity. This review evaluates two alternative schemes for glaucoma care within a hospital, i.e., shared care (SC) and virtual clinics (VCs), whereby non-medical staff are entrusted with more responsibilities, and compares these schemes with the "traditional" ophthalmologist-led outpatient service (standard care). A literature search was conducted in three large bibliographic databases (PubMed, Embase, and Trip), and the abstracts from the prior five annual meetings of the Association for Research in Vision and Ophthalmology were consulted. Twenty-nine were included in the review (14 on SC and 15 on VCs). Patients with low risk of vision loss were considered suitable for these approaches. Among the non-medical staff, optometrists were the most frequently involved. The quality of both schemes was good and improved with the non-medical staff being trained in glaucoma care. No evidence was found on patients feeling disadvantaged by the lack of a doctor visit. Both schemes increased the hospital's efficiency. Both SC and VCs are promising approaches to tackle the upcoming capacity problems of hospital-based glaucoma care.
青光眼患者需要终身治疗，而且青光眼的患病率预计会上升，这将导致许多医院眼科出现治疗能力问题。因此需要新的护理模式来提供所需的治疗能力。本综述评估了医院内两种青光眼护理替代方案，即共享护理（SC）和虚拟诊所（VC），在这两种方案中，非医务人员被赋予了更多职责，并将这些方案与“传统的”由眼科医生主导的门诊服务（标准护理）进行了比较。我们在三个大型文献数据库（PubMed、Embase和Trip）中进行了文献检索，并查阅了视觉与眼科学研究协会前五次年会的摘要。本综述纳入了29项研究（14项关于共享护理，15项关于虚拟诊所）。视力丧失风险较低的患者被认为适合采用这些方法。在非医务人员中，验光师参与最为频繁。两种方案的质量都很好，并且随着非医务人员接受青光眼护理培训而有所提高。没有证据表明患者因没有看医生而处于不利地位。两种方案都提高了医院的效率。共享护理和虚拟诊所都是解决即将出现的医院青光眼护理能力问题的有前景的方法。
