Which glaucoma patients should be monitored at home and exploration of clinician perceptions on home monitoring? a survey of glaucoma specialists in the UK

BMJ Open. 2024 Nov 18;14(11):e080873. doi: 10.1136/bmjopen-2023-080873.

Abstract

Objectives: To identify suitable patients for glaucoma home monitoring and explore clinicians' perceptions of the possible benefits and risks of home monitoring within the National Health Service.

Design: An online survey composed of open-ended and closed-ended questions.

Setting: Secondary care.

Participants: Glaucoma specialists registered with the UK and Eire Glaucoma Society.

Outcome measures: Agreement with clinical scenarios.

Results: The estimated response rate was 68% (n=49). Of 49 participants, 92% (n=45) were consultant ophthalmologists and 71% (n=35) had over 10-year experience. There was a poor agreement regarding an ideal glaucoma patient for home monitoring, with only one scenario achieving over 60% agreement. Most participants believed that home monitoring would be most suitable for low-risk scenarios, rather than high-risk, due to fear of missing progression. In relation to acceptability, key facilitators included the potential to increase healthcare capacity and promote patient safety. However, low clinician trust in equipment reliability and fear of patient harm were reported as concerns.

Conclusions: There was no clear consensus on which patients would benefit most from glaucoma home monitoring. While many clinicians believe home monitoring may enhance healthcare, there were also many concerns about the technologies themselves. Further work to address clinician concerns is warranted.

Research registry registration number: 6213.

Keywords: Glaucoma; Medical ophthalmology; Patients; Surveys and Questionnaires.

MeSH terms

  • Attitude of Health Personnel*
  • Female
  • Glaucoma* / diagnosis
  • Home Care Services
  • Humans
  • Intraocular Pressure
  • Male
  • Middle Aged
  • Monitoring, Ambulatory / methods
  • Ophthalmologists / psychology
  • Surveys and Questionnaires
  • United Kingdom