Shared care for chronic eye diseases: perspectives of ophthalmologists, optometrists and patients.
OBJECTIVE
To report the perspectives of optometrists, ophthalmologists and patients on a model of shared care for patients with chronic eye diseases.


METHODS
Qualitative study of a model of shared care between optometrists and ophthalmologists for patients with stable age-related macular degeneration, diabetic retinopathy and glaucoma, trialled by the Royal Victorian Eye and Ear Hospital in Melbourne during 2007–2009. Semi-structured interviews were conducted with optometrists, ophthalmologists and patients at completion of the project to obtain their perspectives on this model.


RESULTS
Seventeen optometrists submitted expressions of interest to participate, and 12 completed web-based training modules and clinical observerships and adhered to specified examination and reporting protocols. All five participating ophthalmologists and 11 of the optometrists were interviewed. Ninety-eight patients participated and 37 were interviewed. Optometrists not only met ophthalmologists’ expectations but exceeded them, appropriately detecting and referring patients with additional, previously undetected conditions. Patients reported savings in travel time and were satisfied with the quality of care they received. Optometrists, ophthalmologists and patients indicated a general acceptance of shared care arrangements, although there were some issues relating to interprofessional trust.


CONCLUSIONS
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.
Centre for Eye Research Australia, University of Melbourne, Melbourne, VIC, Australia.
Patricia M
PM
O'Connor
C Alex
CA
Harper
Cathy L
CL
Brunton
Sandra J
SJ
Clews
Sharon A
SA
Haymes
Jill E
JE
Keeffe
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002908:Chronic Disease; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000628:therapy; D005128:Eye Diseases / Q000175:diagnosis / Q000628:therapy; D005260:Female; D005901:Glaucoma / Q000175:diagnosis / Q000628:therapy; D019538:Health Care Surveys; D006801:Humans; D007400:Interprofessional Relations; D008268:Macular Degeneration / Q000175:diagnosis / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009885:Ophthalmology; D009907:Optometry; D010348:Patient Care Team; D017060:Patient Satisfaction; D036301:Qualitative Research; D012017:Referral and Consultation; D014850:Waiting Lists