title: Qualitative investigation of patients' experience of a glaucoma virtual clinic in a specialist ophthalmic hospital in London, UK.
abstract: OBJECTIVE
  To explore how patients felt about delivery of care in a novel technician-delivered virtual clinic compared with delivery of care in a doctor-delivered model.
  
  
  METHODS
  A qualitative investigation using one-to-one interviews before and after patients' appointments at either the standard outpatient glaucoma clinic or the new technician-delivered virtual glaucoma clinic (Glaucoma Screening and Stable Monitoring Service, GSMS).
  
  
  METHODS
  A glaucoma clinic based in a tertiary ophthalmic specialist hospital in London.
  
  
  METHODS
  43 patients (38 Caucasian, 5 African/Afro-Caribbean) were interviewed prior to their glaucoma appointment; 38 patients were interviewed between 4 and 6 weeks after their appointment. Consecutive patients were identified from patient reception lists and telephoned prior to their appointment inviting them to participate.
  
  
  RESULTS
  Trust in the patient-provider relationship emerged as a key theme in patients' acceptance of not being seen in a traditional doctor-delivered service. Patients who were well informed regarding their glaucoma status and low risk of progression to sight loss were more accepting of the GSMS. Patients valued the reassurance received through effective communication with their healthcare practitioner at the time of their appointment.
  
  
  CONCLUSIONS
  This study suggests that patients are accepting of moving to a model of service delivery whereby the doctor is removed from the consultation as long as they are informed about the status of their condition and reassured by the interaction with staff they meet. This study highlights the importance of patient engagement when introducing new models of service delivery.
authors.affiliation: NIHR Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.
authors.forename: Aachal
authors.initials: A
authors.lastname: Kotecha
authors.affiliation: NIHR Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.
authors.forename: Karen
authors.initials: K
authors.lastname: Bonstein
authors.affiliation: NIHR Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Cable
authors.affiliation: NIHR Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Cammack
authors.affiliation: NIHR Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Clipston
authors.affiliation: NIHR Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Foster
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D001071:Appointments and Schedules; D003142:Communication; D003376:Counseling; D005260:Female; D005901:Glaucoma / Q000175:diagnosis* / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D008131:London; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D036301:Qualitative Research; D013038:Specialization; D062606:Tertiary Care Centers; D035502:Trust / Q000523:psychology*
keywords: QUALITATIVE RESEARCH