The Bristol Shared Care Glaucoma Study: study design

Area of Science:

• Ophthalmology
• Optometry
• Public Health

Background:

• Glaucoma management requires regular monitoring to detect progression.
• Hospital Eye Services (HES) face increasing demand.
• Community-based optometric care offers a potential solution for managing stable glaucoma patients.

Purpose of the Study:

• To evaluate community-based optometric monitoring against routine Hospital Eye Services (HES) for stable glaucoma patients and glaucoma suspects.
• To assess patient satisfaction with both monitoring approaches.
• To perform a cost analysis of community versus hospital-based care.

Main Methods:

• Four hundred and five subjects were recruited from Bristol Eye Hospital.
• Participants underwent a Gold Standard Assessment (GSA) and were randomized to either community optometric care (204 subjects) or continued hospital care (201 subjects).
• Community care involved six-monthly reviews by glaucoma-trained optometrists, with established referral criteria for progression detection.

Main Results:

• The study compared the effectiveness, patient satisfaction, and cost of community optometric monitoring versus HES for stable glaucoma patients.
• Referral criteria were developed to identify potential glaucomatous progression within the community setting.
• Patient satisfaction and cost-effectiveness were key outcome measures alongside clinical monitoring.

Conclusions:

• Community-based optometric monitoring presents a comparable alternative to traditional Hospital Eye Services for stable glaucoma patients.
• This model may help alleviate HES workload while maintaining quality of care.
• Further analysis of patient satisfaction and cost-effectiveness is crucial for implementation.