A Mixed-Methods Evaluation of a Community-Based Glaucoma Check Service in Hackney, London, UK.

Holdsworth, E; Datta, J; Marks, D; Kuper, H; Lee, H; Leamon, S; Lindfield, R; Wormald, R; Clarke, J; Elkarmouty, A; and +1 more...Macdowall, W (2016) A Mixed-Methods Evaluation of a Community-Based Glaucoma Check Service in Hackney, London, UK. Ophthalmic epidemiology. pp. 1-9. ISSN 0928-6586 DOI: 10.1080/09286586.2016.1272702
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: To evaluate the uptake, feasibility and acceptability of a general practice-based optometrist-led glaucoma check service. The service targeted people of black Caribbean and black African descent aged 40-65 years, resident in Hackney, London, United Kingdom.<br/> : The study used a mixed-method design, including analysis of service data, prospective audit of secondary care referrals patient survey, cost-consequence analysis, and interviews with staff involved in developing and implementing the service.<br/> : A total of 3040 patients were invited to undergo the free check; 595 (19.6%) booked an appointment and 461 (15.2%) attended. Overall, 31 patients (6.8%) were referred to secondary care, of whom 22 attended and were assessed for glaucoma. Four were diagnosed with glaucoma and eight with suspected glaucoma, i.e. 2.6% of patients who underwent the check. The cost per patient identified with suspected or confirmed glaucoma was £9,013. Staff who were interviewed suggested that patients who attended might be those who routinely attended optometrist appointments, however only 62.4% of survey respondents reported having had an eye examination in the previous two years, and 11.4% of women and 16.0% of men reported never having had an eye examination.<br/> : This study represents one possible configuration for a glaucoma case-finding service, and it contributes to a wider debate about whether screening, targeted or otherwise, should be offered in the UK. Our findings suggest that general practice is an acceptable setting and that such a service may reach some people not previously engaged with primary eye care services.<br/>


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