Quality indicators in a community optometrist led cataract shared care scheme

Bowes, Oliver; Shah, Poonam; Rana, Mrinal; Farrell, Sarah; Rajan, Madhavan S.

doi:10.1111/opo.12444

Cited by 4 publications

(5 citation statements)

References 17 publications

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“…These direct pathways have been introduced to ensure that the ‘Action on Cataracts’ guidelines were followed, and that patients referred for cataract surgery were only seen within the HES when they had reduced measured vision, were symptomatic and expressed a willingness for surgery. Two early 47 , 49 and one more recent study 36 reported that surgery listing rates were significantly higher (83%–87%) when compared to conventional referral pathways (63%–78%).…”

Section: Resultsmentioning

confidence: 98%

“…El-Abiary et al, 2021 23 Muttuvelu et al, 2021 8 Wang et al, 2021 50 Kern et al, 2020 7 Phu et al, 2020 34 Konstantakopoulou et al, 2018 37 Kortuem et al, 2018 66 Ford et al, 2019 51 Forbes et al, 2017 25 Kotecha et al, 2017 70 Mason et al, 2017 28 Ly et al, 2017 38 Balaskas et al, 2016 65 Ly et al, 2016 39 El-Assal et al, 2015 41 Keenan et al, 2015 43 Ratnarajan et al, 2015 44 Roberts et al, 2015 42 Goudie et al, 2014 59 Ratnarajan et al, 2013a 6 Ratnarajan et al, 2013b 45 Trikha et al, 2012 62 Devarajan et al, 2011 54 Parkins et al, 2011 55 Ang et al, 2009 48 Park et al, 2009 47 Hanson et al, 2008 61 Patel et al, 2006 64 Hind et al 2022 68 Huang et al, 2020 33 Gunn et al, 2019 35 Bowes et al, 2018 36 McAlinden et al, 2016 40 Borooah et al, 2013 60 Kelly et al, 2011 63 Bourne et al, 2010 46 Cameron et al, 2009 4 Lash et al, 2006 49 Retrospective and Prospective (n=3)…”

Section: Retrospective (N=29)mentioning

confidence: 99%

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The effectiveness of interventions for optometric referrals into the hospital eye service: A review

Carmichael,

Abdi,

Balaskas

et al. 2023

Ophthalmic Physiologic Optic

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PurposeOphthalmic services are currently under considerable stress; in the UK, ophthalmology departments have the highest number of outpatient appointments of any department within the National Health Service. Recognising the need for intervention, several approaches have been trialled to tackle the high numbers of false‐positive referrals initiated in primary care and seen face to face within the hospital eye service (HES). In this mixed‐methods narrative synthesis, we explored interventions based on their clinical impact, cost and acceptability to determine whether they are clinically effective, safe and sustainable. A systematic literature search of PubMed, MEDLINE and CINAHL, guided by the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA), was used to identify appropriate studies published between December 2001 and December 2022.Recent FindingsA total of 55 studies were reviewed. Four main interventions were assessed, where two studies covered more than one type: training and guidelines (n = 8), referral filtering schemes (n = 32), asynchronous teleophthalmology (n = 13) and synchronous teleophthalmology (n = 5). All four approaches demonstrated effectiveness for reducing false‐positive referrals to the HES. There was sufficient evidence for stakeholder acceptance and cost‐effectiveness of referral filtering schemes; however, cost comparisons involved assumptions. Referral filtering and asynchronous teleophthalmology reported moderate levels of false‐negative cases (2%–20%), defined as discharged patients requiring HES monitoring.SummaryThe effectiveness of interventions varied depending on which outcome and stakeholder was considered. More studies are required to explore stakeholder opinions around all interventions. In order to maximise clinical safety, it may be appropriate to combine more than one approach, such as referral filtering schemes with virtual review of discharged patients to assess the rate of false‐negative cases. The implementation of a successful intervention is more complex than a ‘one‐size‐fits‐all’ approach and there is potential space for newer types of interventions, such as artificial intelligence clinical support systems within the referral pathway.

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Section: Resultsmentioning

confidence: 98%

Section: Retrospective (N=29)mentioning

confidence: 99%

The effectiveness of interventions for optometric referrals into the hospital eye service: A review

Carmichael,

Abdi,

Balaskas

et al. 2023

Ophthalmic Physiologic Optic

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“…57 We found examples of vertical integration strategies to mitigate this, including shared-care between optometrists and ophthalmologists in the UK for people with glaucoma 24 and cataract. 59 A common theme of studies reporting elements of service integration was the importance of good communication between providers and enabling technology-including teleophthalmology and secure electronic health information systems-to enhance efficiency and timeliness of the service. 57 Refractive error correction is a condition that highlights the importance of integrated eye care services.…”

Section: Discussionmentioning

confidence: 99%

Primary eye health services for older adults as a component of universal health coverage: a scoping review of evidence from high income countries

Goodman

Hamm

Tousignant

et al. 2023

The Lancet Regional Health - Western Pacific

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“…To ensure appropriate use of time and resources schemes have been set up for additional optometrist training to perform cataract pre-assessments. Bowes et al created an annual accreditation course for Cambridgeshire optometrists in an effort to improve the quality of referrals to ophthalmology [ 9 ]. And Gaskell et al [ 4 ] developed a specialist educational course to accredit optometrists in the assessment of cataract.…”

Section: Discussionmentioning

confidence: 99%

A proposed redesign of elective cataract services in Scotland – pilot project

Dhillon

Ghazal

Harcourt

et al. 2021

Eye

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Background The demand for cataract surgery is expected to increase by 25% in the next 10 years as the result of our ageing population. A new pathway is being proposed to improve efficiency by utilising the new General Ophthalmic Services code 2.9 for community optometrists in Scotland for Cataract Referral Refinement and Consenting process. A pilot project has been undertaken at NHS Grampian enabling patients to be assessed and undergo surgery at a single visit to the Eye Outpatient Department. Objectives To determine the suitability of community cataract referrals for a one stop cataract surgery service and target areas for referral refinement. Methods 300 consecutive cataract referrals were assessed for suitability for one stop cataract surgery, determined by the documentation of pertinent clinical findings. All suitable referrals were offered a telephone consultation to confirm suitability and those patients were subsequently offered on the day cataract surgery. A telephone led patient satisfaction survey was then completed. Results 71 (24%) suitable patients were identified from vetting 300 referrals. 54 patients from this group were selected for one-stop service following telephone consultation. 51 patients subsequently attended for surgery. There was a 100% conversion rate to same day surgery and no intraoperative complications reported. Conclusion The waiting time was significantly reduced, by 30 weeks, for one-stop patients. Approximately one quarter of referrals were deemed suitable for a one-stop service. Many more patients may have been suitable for same day surgery but there was not sufficient information in their referrals to determine their suitability.

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Quality indicators in a community optometrist led cataract shared care scheme

Cited by 4 publications

References 17 publications

The effectiveness of interventions for optometric referrals into the hospital eye service: A review

The effectiveness of interventions for optometric referrals into the hospital eye service: A review

Primary eye health services for older adults as a component of universal health coverage: a scoping review of evidence from high income countries

A proposed redesign of elective cataract services in Scotland – pilot project

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