A collaborative care pathway for patients with suspected angle closure glaucoma spectrum disease.
Clin Exp Optom
; 103(2): 212-219, 2020 03.
Article
in En
| MEDLINE
| ID: mdl-31119793
ABSTRACT
BACKGROUND:
Currently, no specific collaborative care pathway exists that distinguishes open angle glaucoma from narrow angle or angle closure disease. This study evaluates a newly developed referral and collaborative care pathway specifically for patients with angle closure spectrum disease.METHODS:
The medical records of consecutive patients referred to the Centre for Eye Health for glaucoma assessment were examined, six months before (Pre Suite) and after (Post Suite) the introduction of a novel referral pathway for anterior chamber angle assessment (Angle Suite). Patient demographic and clinical data, the referral letter and practitioner characteristics were extracted.RESULTS:
Angle Suite (n = 77) patients had an appointment much sooner compared to Pre (n = 383) and Post Suite (n = 425) patients (p < 0.0001). Following the introduction of Angle Suites, there was a reduction of incidental angle closure disease found in routine, non-angle closure glaucoma assessment. Onward referral was required by 36.4 per cent of patients referred for suspected angle closure disease, while the rest could be discharged back into the community (13.0 per cent) or reviewed at the Centre for Eye Health (50.6 per cent). Multinomial logistic regression found that the presence of an angle description in the referral letter improved the true positive rate for angle closure disease (p < 0.0001).CONCLUSIONS:
The clinical pathway may reduce the number of incidental angle closure patients and improved the timeliness of appropriate clinical care delivered to a subset of patients who may benefit from prompt medical attention. This pathway provides an opportunity for appropriately staffed and equipped collaborative care clinics to reduce the burden on tertiary level ophthalmic facilities.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Glaucoma, Angle-Closure
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Critical Pathways
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Disease Management
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Tomography, Optical Coherence
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Intraocular Pressure
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Anterior Eye Segment
Type of study:
Diagnostic_studies
/
Guideline
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Observational_studies
Limits:
Female
/
Humans
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Male
/
Middle aged
Language:
En
Journal:
Clin Exp Optom
Journal subject:
OPTOMETRIA
Year:
2020
Document type:
Article
Affiliation country: