Trial upskills GPs to perform intravitreal injections

More GPs could soon be upskilled to perform intravitreal injections (IVIs) in a bid to bolster treatment access in rural communities.
 
It comes as the RACGP joins forces with its ophthalmologist colleagues to call for greater access to ophthalmic care, saying much of it is ‘largely restricted to private urban clinics’.
 
In a new joint statement, the RACGP, Royal Australian and New Zealand College of Ophthalmologists (RANZCO), and Australian College of Rural and Remote Medicine (ACRRM) say appropriate training pathways, supervised skills acquisition and sustainable service delivery models must all be bolstered.
 
Currently, around 11,000 Australians are receiving IVIs for retinal vein occlusion, but many public hospitals do not provide these services and 84% of ophthalmologists live in major cities.
 
This lack of access has led 3% of patients to stop IVIs due to travel distance.
 
In response, RANZCO, RACGP, and ACRRM are developing an upskilling program for GPs and Rural Generalists (RGs) to perform IVIs with remote supervision provided by a mentoring ophthalmologist or visiting ophthalmology team.
 
While it is still early days, the pilot program hopes to target regions of critical need based on burden of disease and current service gaps.
 
‘Upskilling curriculum developed by RANZCO focuses on the safe and effective administration of IVIs, with online modules and educational materials readily accessible,’ the joint statement says.
 
‘There will be supervised clinical training followed by annual CPD, delivered in collaboration with mentoring ophthalmologists during their outreach services in the GP’s or RG’s region.
 
‘RGs and GPs participating in the initiative are not substitutes for ophthalmologists, but complementary clinicians working within clearly defined scopes of practice and collaborative care models to improve access to timely treatment in communities where specialist services are limited.’
 
RACGP Rural Chair Associate Professor Michael Clements helped in developing the trial’s concept and said it will bring crucial care back to patients.
 
‘Eye care is something that our remote patients often do without – it’s not something that they delay or that costs them more time or money to get done, it’s just that they do without,’ he told newsGP.
 
‘By looking at expanding the list of people that can actually do these injections and use the skills that we’ve already got there, which is the RGs and the GPs, we’re really excited that this is going to open up the opportunities for treatment.
 
‘GPs are really well suited to taking on this additional skill set and with the right training and the right support from the ophthalmologists and having the right linkages with ophthalmologists and the tertiary hospital, we really can bring a much higher level of care to these patients.’
 
According to the joint statement, the pilot will incorporate a ‘robust evaluation framework assessing patient outcomes, service accessibility and workforce sustainability’.
 
‘By enabling GPs and RGs to deliver evidence-based ophthalmic procedures such as IVIs, we collectively support a more resilient and responsive health system for rural and remote Australians, with the shared aim of optimising health equity and service delivery across Australia,’ it said.
 
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ACRRM eye conditions ophthalmologist RANZCO