2.3.2. HCP Working in the Clinic

In this review, ophthalmologists will be referred to as Glaucoma Experts (GEs). No specific criteria for the training were used, since this certification process has only been established in recent years through the collaboration between the European Board of Ophthalmology (EBO) and the European Glaucoma Society (EGS) [25].

The non-medical staff may consist of ophthalmic nurse practitioners (ONP), orthoptists, optometrists and ophthalmic technicians, with different training and responsibilities [26].

Kappa (κ) values were used to measure the chance-corrected agreement between HCPs on a scale of 0.00 to 1.00, indicating no to perfect agreement, respectively. The nomenclature of Landis and Koch was adopted for denominating different kappa ranges as follows: 0.00–0.20 as "slight", 0.21–0.40 as "fair", 0.41–060 as "moderate", 0.61–0.80 as "substantial" and 0.81–1.00 as "almost perfect" agreement [27].

#### 2.3.3. Organization of the Clinic

In standard care (StC) of glaucoma, patients have their appointment with a GE who makes the diagnosis, sets up a management plan during the initial assessment, and decides on a possible change of the management plan during follow-up.

In SC, the non-medical staff assesses patients during most appointments alone. At regular intervals, or earlier if the patient meets the referral criteria, an appointment is planned with the GE, who will examine the patient face-to-face, as is the case in the StC.

In a VC, both HCPs assess the patient at each appointment, with the non-medical staff assessing the patient in a face-to-face consultation and the GE examining the patient remotely, by virtually reviewing the data collected by the non-medical staff.

#### **3. Results of Shared Care Studies**

#### *3.1. Study Selection*

From the 400 articles identified, 13 were selected, complemented with one additional article obtained from the reference lists. The processes of identification, screening, duplicates removal and full-text assessment are shown in Figure 1.

#### *3.2. Description of the Included Articles*

Illustration of the baseline characteristics of the selected articles, including study design, year, location, hospital, SC clinic and population (Table 1).

#### 3.2.1. Recommendations for Shared Glaucoma Care

Two articles provided a model of reference and recommendations on how glaucoma care could benefit from involving the non-medical staff [28,29]. The recommendations of the Australian and New Zealand Glaucoma Interest Group and the Royal Australian and New Zealand College of Ophthalmologists (ANGIG&RANZCO) [28] followed the National Health and Medical Research Council (NHMRC) guidelines [30], and the recommendations from the Canadian Glaucoma Society Committee (CGSC) [29] followed the Canadian Ophthalmology glaucoma clinical practice guidelines (COSgcpg) [31]. For their risk assessment, however, they used the same guidelines [32]. They did not examine the performance of the non-medical staff nor the performance of a SC scheme in general.

**Figure 1.** Study selection PRISMA flow chart on Shared Care. Abbreviations: ARVO = Annual Meeting of the Association for Research in Vision and Ophthalmology; *n* = amount.

3.2.2. Implementation and Performance of SC Clinics

These articles compared the performance of the non-medical staff with that of the GE, or compared SC in general with StC [33–44]. All articles concentrated on an actual clinic performing SC, including the glaucoma follow-up unit in the Rotterdam Eye Hospital (SC-GFU) [36–38], the Mayo clinic (SC-MC) [33–35], the Moorfield Eye Hospital (SC-MEH) [40,42], the Queen's medical centre (SC-QMC) [39], the Stable Glaucoma Clinic in New Zealand (SC-SGC) [43], the Glaucoma Management Clinic in Australia (SC-GMC) [44] and one established between the Royal Victorian Eye & Ear Hospital and the Australian College of Optometry (SC-RVAC) [41]. The corresponding StC clinic in each hospital is referred as "StC—(name of the corresponding clinic/hospital)".

#### *3.3. The Organization: Implementing SC for Glaucoma*
