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. 2021 Sep;49(7):672-685.
doi: 10.1111/ceo.13976. Epub 2021 Aug 12.

How can we improve the quality of cataract services for all? A global scoping review

Miho Yoshizaki  1 , Jacqueline Ramke  1   2 , Justine H Zhang  1 , Ada Aghaji  3 , João M Furtado  4 , Helen Burn  5 , Stephen Gichuhi  6 , William H Dean  1   7 , Nathan Congdon  8   9   10 , Matthew J Burton  1   11 , John Buchan  1
Affiliations

How can we improve the quality of cataract services for all? A global scoping review

Miho Yoshizaki et al. Clin Exp Ophthalmol. 2021 Sep.

Abstract

Background: Cataract is a leading cause of blindness and vision impairment globally. Cataract surgery is one of the most frequently performed operations worldwide, but good quality services are not universally available. This scoping review aims to summarise the nature and extent of published literature on interventions to improve the quality of services for age-related cataract globally.

Methods: We used the dimensions of quality adopted by WHO-effectiveness, safety, people-centredness, timeliness, equity, integration and efficiency-to which we added planetary health. On 17 November 2019, we searched MEDLINE, Embase and Global Health for manuscripts published since 1990, without language or geographic restrictions. We included studies that reported quality-relevant interventions and excluded studies focused on technical aspects of surgery or that only involved children (younger than 18 years). Screening of titles/abstracts, full-text review and data extraction were performed by two reviewers independently. Studies were grouped thematically and results synthesised narratively.

Results: Most of the 143 included studies were undertaken in high-income countries (n = 93, 65%); 29 intervention groups were identified, most commonly preoperative education (n = 17, 12%) and pain/anxiety management (n = 16, 11%). Efficiency was the quality element most often assessed (n = 58, 41%) followed by people-centredness (n = 40, 28%), while integration (n = 4) and timeliness (n = 3) were infrequently reported, and no study reported outcomes related to planetary health.

Conclusion: Evidence on interventions to improve quality of cataract services shows unequal regional distribution. There is an urgent need for more evidence relevant to low- and middle-income countries as well as across all quality elements, including planetary health.

Keywords: cataract services; global eye health; quality; universal health coverage.

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Conflict of interest statement

Conflict of interest

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1. Summary of study selection
Figure 2
Figure 2. Number of publications by decade and primary quality element being addressed by the intervention
Figure 3
Figure 3
The extent of evidence for interventions addressing each quality element of cataract services, by GBD super-region. Two studies categorised as HIC in Table 1 (WB criteria) are in Central Europe, Eastern Europe and Central Asia GBD super-region here
See this image and copyright information in PMC

Comment in

  • Quality of eye care: Time to act.
    Resnikoff S. Resnikoff S. Clin Exp Ophthalmol. 2021 Sep;49(7):647-648. doi: 10.1111/ceo.13997. Epub 2021 Sep 10. Clin Exp Ophthalmol. 2021. PMID: 34505746 No abstract available.

References

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