Shared care for chronic eye diseases: perspectives of ophthalmologists, optometrists and patients

Abstract

Shared care between local optometrists and hospital-based ophthalmologists can help to reduce patient waiting time for review and offers an opportunity for these two groups of eye care professionals to collaborate in providing localised care for the benefit of patients. However, trust and relationship building need to be further developed.

The Effectiveness, cost-effectiveness and acceptability of Community versus Hospital Eye Service follow-up for patients with neovascular age-related macular degeneration with quiescent disease (ECHoES): a virtual randomised balanced incomplete block trial

“…Shared care schemes are also attractive to patients who would find it more convenient to be monitored closer to their home. 34,35 In line with previous research, the service users described how they were frustrated at the lack of support and information that they had received about their condition. 36,37 Consequently, they felt that being monitored in the community would enable them to build up a relationship with one optometrist, with whom there would be more of an opportunity to receive better support and information.…”

“…Shared care research for a variety of eye conditions has reported that, although web-based training is a convenient and effective option, it is not representative of clinical practice and may not be appropriate for teaching practical clinical skills which need to be developed through attendance at a training course. 35,41 Health professionals in the current study also highlighted that face-to-face training of this kind would provide reassurance to the ophthalmologists that optometrists were being trained to a high standard and further encourage interprofessional collaboration.…”

“…38 Furthermore, interviews with service users who had declined to take part in a shared care scheme for a range of eye diseases (including nAMD) did so because of their familiarity with, and the reputation of, the HES. 35 Overall, the health professionals described poor collaboration between community optometrists and ophthalmologists working in the HES. Many participants, particularly the ophthalmologists and service users, voiced concerns about a potential delay between primary and secondary care if retreatment was required.…”

“…This is a new finding, as previous research exploring patient perceptions of shared care for a range of eye conditions has not found this to be an issue. 34,35,39,40 Long-term research has demonstrated that recurrence of neovascular activity is common, 15 and any delay beyond the recommended interval may cause patients to unnecessarily lose vision permanently. 12 Given that vision can deteriorate in a short time if nAMD DOI: 10.3310/hta20800 HEALTH TECHNOLOGY ASSESSMENT 2016 VOL.…”

“…Separate rather than mixed focus groups were undertaken to capture any potential interprofessional trust issues which emerged from previous research. 35 One-to-one interviews were conducted with other health professionals because it was not possible to ascertain a convenient location, date and time to organise a third focus group. These interviews provided a rich account of the perceived feasibility and acceptability of a shared care scheme and allowed the findings from the focus groups to be followed up further and explored in-depth.…”