Outcomes of a pilot study of community-based, collaborative glaucoma care in a tertiary referral public glaucoma clinic

ABSTRACT

Purpose: To evaluate the outcomes of the Glaucoma Community Collaborative Care Program (G3CP) from the Royal Victorian Eye and Ear Hospital (RVEEH), Melbourne. Method: The program enrolled community optometrists in a shared care model with the RVEEH Glaucoma Unit. Patients classified as low risk and/or stable glaucoma patients were recruited according to RANZCO Collaborative Care Guidelines. The program's aims were to increase access and provide timely glaucoma care, contribute to the continuing education of optometrists and to be scalable to accommodate increased future demand. Results: The pilot program enrolled 104 patients between March 2019 and April 2020. The uptake rate by patients offered the G3CP was 73%. Clinical outcomes showed 93% of patients had stable glaucoma over the period and all had timely reviews. There was 95% agreement between the enrolled optometrists and a RVEEH Glaucoma Specialist. Surveys of patient and optometrist satisfaction demonstrated high acceptability. The challenges identified were frequent changes in the optometry network (up to 50% of originally enrolled), low recruitment (35% of predicted) and low quality of information shared (40% of optical coherence tomography tests reviewed were too degraded for adequate review). Conclusion: The G3CP pilot provided timely care to the patients enrolled and created additional capacity in outpatients, which has become even more important with the increased demand caused by the COVID-19 pandemic. With acceptability and feasibility of the project demonstrated, it is intended that this model of collaborative care will continue;however, to enable scalability, several challenges will need to be addressed. Genetics.