Journal: BMJ Open Ophthalmology

Article Title: Cost-effectiveness of monitoring ocular hypertension based on a risk prediction tool

doi: 10.1136/bmjophth-2024-001741

Figure Lengend Snippet: A schematic of the model structure. Diagnosed ocular hypertension (OHT) patients with intraocular pressure (IOP) of ≥24 mm Hg entered the model with a set of predefined individual characteristics related to their risk of conversion to glaucoma. An initial decision on treatment was made by a secondary-care health professional. Patients without treatment were referred for annual check-ups in primary care and can be referred back to secondary care following an unfavourable check-up. Patients who met the initial treatment rule in secondary care were treated with prostaglandin analogues (80% of them) or selective laser trabeculoplasty (20% of them). Treated patients with ‘on target’ IOP (ie, IOP reduced by 20% or more compared with the baseline IOP after treatment) were returned to primary care after one clinical visit for continued monitoring, while the treatment was escalated for ‘off-target’ patients following the treatment sequence. For treated or untreated patients monitored in the primary care settings, an observed conversion to glaucoma would trigger a referral to secondary care, and an immediate eye assessment was assumed to be conducted by the hospital ophthalmologists/optometrists to confirm the evidence of glaucoma. Patients with negative glaucoma assessment results would be referred back to primary care, and those with positive assessment results were remained in secondary care. In addition, treated OHT patients monitored in primary care with IOP measures deemed ‘off-target’ would be referred to secondary care. (t) means it’s a time-to-event.

Article Snippet: A cohort of 50 000 patients with diagnosed OHT were used in the simulation using Treeage (2023 R2.0) for the base-case analysis (the model is available from the authors on request).

Techniques: Analogues, Sequencing