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Patients' experiences and preferences with co-managed care in a cataract pathway
  1. E J van Vliet1,2,
  2. N J Reus3,
  3. W Sermeus1,
  4. J M H Vissers4,
  5. J C A Sol3,
  6. H G Lemij1,3
  1. 1School of Public Health, Faculty of Medicine, Center for Health Services and Nursing Research, Catholic University Leuven, Leuven, Belgium
  2. 2Rotterdam Ophthalmic Institute, Rotterdam, The Netherlands
  3. 3Rotterdam Eye Hospital, Rotterdam, The Netherlands
  4. 4Institute of Health Policy and Management, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
  1. Correspondence to Ellen J van Vliet, Rotterdam Ophthalmic Institute, PO Box 70030 3000LM Rotterdam, The Netherlands; ellen.vanvliet{at}


Background/aims Co-managed care in cataract pathways allows ophthalmologists more time to treat other patients. However, little is known on how patients experience pathways that greatly reduce the amount of time spent with ophthalmologists.

Purpose To determine experiences and preferences of cataract patients with co-managed postoperative care.

Methods In a nested-case control study, 194 patients who received their first-day review and final review by an ophthalmologist and 289 patients who received a telephone first-day review by a nurse and a final review by an optometrist were included. The Consumer Quality Index Cataract Questionnaire was used to measure patients' experiences with the quality of care after uncomplicated first-eye cataract surgery.

Results Patients in the co-managed care pathway reported similarly good experiences with the quality of care as patients who received their reviews by an ophthalmologist. Patients who were reviewed by a nurse reported to prefer the same first-day review method significantly more often than those who were reviewed by an ophthalmologist. Most patients preferred the final review by an ophthalmologist.

Conclusion Overall, patients with cataract highly rated co-managed care pathways without any postoperative contact with ophthalmologists. Nevertheless, patients still preferred ophthalmologists for their final review to optometrists. Any added patients' benefits should be clearly determined before substituting activities from ophthalmologists to other care professionals.

  • Cataract surgery
  • patient satisfaction
  • clinical pathway
  • lens and zonules

Statistics from


  • Funding Rotterdam Eye Hospital Research Foundation, Rotterdam, The Netherlands.

  • Competing interests None.

  • Ethical approval Our research study adhered to the tenets of the Declaration of Helsinki. The institutional human experimentation committee of the Erasmus Medical Centre Rotterdam approved the study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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