<p>Providing a Safe and Effective Intravitreal Treatment Service: Strategies for Service Delivery</p>

Abstract

An aging population leads to increasing demand for medical retina services with chronic diseases being managed in long-term care pathways. Many hospital services struggle to deliver efficient and effective MR care due, at least in part, to infrastructure that does not expand responsively enough to meet the increased demand. A steering committee of retinal specialists from a variety of UK NHS hospital ophthalmology departments with experience of leading and managing NHS retinal services in the intravitreal era came together for the generation of this document to review and compile key aspects that should be considered when optimising intravitreal treatment capacity within MR services. This article aims to provide a useful collation and signposting of key published evidence, consensus and insights on aspects of delivering an intravitreal service, including treatment regimens, virtual clinics, staff training and governance, telemedicine and information technology, and data collection and key performance indicators. The objective is to equip ophthalmologic healthcare professionals with the necessary tools to develop and adapt their local service in the face of current and projected increased demand.

Meta-Analysis of the Efficacy and Safety of Tranexamic Acid in Spinal Surgery

“…In addition, although the dosage of TXA is not the source of heterogeneity, the optimal dosage still needs further research [21][22][23]. Despite this, clinicians can still adopt a safe and effective TXA dosing regimen according to the actual situation of the patient to reduce the amount of bleeding during the perioperative period of spinal surgery [24][25][26]. However, there is also the limitation of this study.…”

<p>Trends in Real-World Neovascular AMD Treatment Outcomes in the UK</p>

“…This will require long-term use of proactive treatment regimens and avoidance of undertreatment, patient education, staff training and governance, greater use of virtual clinics, telemedicine and information technology infrastructure, key performance indicators and adequate resources. 76,77 Conclusion UK real-world outcomes have improved over the last decade with the adoption of more proactive treatment regimens and service improvements but are still not consistently as impressive as those from registration clinical trials or some international observational cohorts with long-term data. The adoption of prospective registries can inform key stakeholders of important changes in clinical practice outcomes in a more timely manner.…”

The changing landscape for the management of patients with neovascular AMD: brolucizumab in clinical practice

“…The chronic, progressive nature of the disease can have a significant impact on patients’ quality of life, imposing substantial time burden, limiting their ability to perform day-to-day tasks and have a significant emotional impact [ 4 , 9 ]. Insufficient medical retina service capacity, delays in treatment initiation and poor patient adherence can all contribute to suboptimal outcomes for patients [ 4 , 9 , 10 ]. The progressive nature of the disease means that as time passes the economic and time burdens for caregivers and services increase [ 9 ], with the care need outweighing the growth of the resources allocated to clinical services [ 10 ].…”

“…Insufficient medical retina service capacity, delays in treatment initiation and poor patient adherence can all contribute to suboptimal outcomes for patients [ 4 , 9 , 10 ]. The progressive nature of the disease means that as time passes the economic and time burdens for caregivers and services increase [ 9 ], with the care need outweighing the growth of the resources allocated to clinical services [ 10 ]. The need for continued treatment and monitoring results in a significant financial impact on the health service [ 11 ].…”