Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Specialised Independent Prescribing Optometrists Delivering a Community Shared-Care Glaucoma Service: A Pilot Study

Version 1 : Received: 27 March 2021 / Approved: 30 March 2021 / Online: 30 March 2021 (13:52:26 CEST)

How to cite: Golash, V.; Ansari, E. Specialised Independent Prescribing Optometrists Delivering a Community Shared-Care Glaucoma Service: A Pilot Study. Preprints 2021, 2021030744 (doi: 10.20944/preprints202103.0744.v1). Golash, V.; Ansari, E. Specialised Independent Prescribing Optometrists Delivering a Community Shared-Care Glaucoma Service: A Pilot Study. Preprints 2021, 2021030744 (doi: 10.20944/preprints202103.0744.v1).

Abstract

Aim: Reporting 3 year outcomes of a community shared care scheme run by specialised independent prescribing (IP) optometrists for stable glaucoma and ocular hypertension (OHT) patients in West Kent, England. Purpose: Shared Care Schemes for glaucoma exist to alleviate the burden on Hospital Eye Services (HES) glaucoma clinics. We studied the effectiveness of community care by highly trained and qualified IP optometrists in terms of disease stability and referral rate into HES.Methods: Retrospective longitudinal review of 200 eyes with stable early to moderate stage glaucoma and OHT followed-up in two specialist optometry practices. Outcome measures included visual field mean deviation (VFMD), intraocular pressure (IOP), changes to treatment and referral rate into HES. Inclusion criteria included all patients with OHT and glaucoma (open angle and primary angle closure) referred for community follow-up. Incomplete data sets were excluded.Results: Mean age 71yrs (range 28 - 93yrs) and equal male: female ratio. n= 159 at year 3. The results for both outcomes showed no significant change from baseline at 12 or 24-month time points. However, a significant change from baseline at 36 months was observed for both outcomes: mean reduction of 0.7 mmHg in IOP, and a mean reduction of 0.3 dB in VFMD. There was a statistically significant change in the number of drops used at 36 months (p=0.001). 11 patients had a change in medication within 3 years. One patient was referred back to HES for uncontrolled IOP and consideration of trabeculectomy.Conclusion: Community follow-up of stable cases of glaucoma and OHT by highly qualified IP optometrists was safe, with stability of disease maintained and few referrals back to HES.

Subject Areas

glaucoma; independent prescibing; optometrist; visual fields; intraocular pressure; shared care

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