2004-08: Monitoring of stable glaucoma patients: evaluation of the effectiveness and efficiency of a Glaucoma follow-up unit, staffed by non-physician Health Care Professionals, as an intermediate step towards glaucoma monitoring in primary care.
The aim of this study is to evaluate an organizational intervention (a Glaucoma follow-up unit) for monitoring stable glaucoma patients, staffed by other Health Care Professionals (HCP) than ophthalmologists. Based on the experiences acquired through this form of substitution within the hospital organization, and exploration of foreseeable effects of costs, conditions are formulated that need to be fulfilled for successful implementation in a primary care setting. This study is a RCT combined with an extensive process evaluation and feasibility study including patients with stable glaucoma, ophthalmologists providing usual care and non-physician HCPs at the follow-up unit. For the feasibility study additional stakeholders such as local insurers will be included. The intervention is a Glaucoma follow-up unit located within The Rotterdam Eye Hospital where stable glaucoma patients are monitored by ophthalmic technicians/primary care optometrists. Outcome measures are defined as the difference between the intraocular target pressure and actual pressure, number of changes in treatment strategy, patients (%) referred from the follow-up unit to the ophthalmologist, patients' compliance, HCPs' compliance to the care pathway and GDx.