Approach to collaborative glaucoma care in New Zealand: An update

Glaucoma Community Care: Does Ongoing Shared Care Work?

“…This has possible beneficial implications in reducing the long wait times for non-urgent, specialist care in the public health system in Australia and other countries that seek to provide universal health care [26]. Re-referral to the glaucoma management clinic for a specialists' opinion occurred less often (260/1,224, 21%) at a level similar to previous studies (ranging from 13.2% to 55%) [1,7,9]. Shared care patients also experienced an improvement in loss to follow up and a median time delay of just two days between the actual and recommended review period.…”

“…These results add to the growing body of evidence showing that a team approach provides an effective solution for managing the ongoing care burden in chronic stable glaucoma cases at low risk of vision loss for the benefit of patient outcomes [6,7,25]. Contrary to other vertical integrated care schemes, which typically shift pre-existing, stable patients from a public hospital outpatients department to a community care model, patients in this scheme were identified and referred directly by primary care providers.…”

“…The majority (87%) of all consultations were also seen within one month of the recommended time frame. This is valuable because fewer and shorter delays in care translate to a lower incidence of overall disease progression, and thus better patient outcomes [7].…”

“…In Australia, there are only 990 qualified ophthalmologists to meet the demand and only 16 per cent are employed in the public sector [4]. These ophthalmology workforce numbers are not expected to grow in line with the expansion of the aged population [5], which has thus led to a growing global interest in glaucoma shared care models [1,[6][7][8][9][10][11][12][13].…”

“…In glaucoma, such schemes typically aim to better utilise health care resources through the vertical integration of public ophthalmology departments and community optometrists [13]. Optometrists with specific training reach high degrees of agreement with ophthalmologists in clinical decision making [7,[15][16][17]. Suitably trained optometrists have also shown good adherence to guidelines regarding initial treatment decisions and the timing of regular monitoring [8,18].…”