Task shifting of intraocular injections from physicians to nurses: a randomized single-masked noninferiority study

Stine Bolme, Tora Sund Morken, Turid Follestad, Torben Lykke Sørensen, Dordi Austeng

Publikation: Bidrag til tidsskriftArtikelForskningpeer review


PURPOSE: To test if task shifting of intraocular injections to nurses in a real-world setting can result in similar visual function outcome with equal safety profile.

METHOD: All patients with either age-related macular degeneration, retinal vein occlusion or diabetic macular oedema remitted to intraocular injections at a tertiary ophthalmology department in Norway between March 2015 and May 2017, were asked to participate. The participants were randomized to either nurse- or physician-administered intraocular injections of anti-vascular endothelial growth factor. The primary outcome measure was change in best-corrected visual acuity from baseline to 1-year follow-up. The mean difference in the primary outcome between the groups was analysed by a noninferiority test with a margin of three letters in disfavour of the nurse group. Adverse events were recorded.

RESULTS: Three hundred and forty-two patients entered the study. Two hundred and fifty-nine completed the 1-year follow-up and were included in the study sample for the analysis of the primary outcome. Nurse-administered intraocular injections were noninferior to physician-administered injections with 0.7 and 1.6 letters gained, respectively (95% CI of the mean difference, -2.9 to 1.0; p = 0.019, one-sided t-test). Two thousand and seventy-seven injections and three ocular adverse events were recorded.

CONCLUSION: Task shifting of intraocular injections to nurses can be performed without increased risk to visual function. Such a task shift can alleviate the burden of performing intraocular injections in ophthalmology departments. To our knowledge, this is the first RCT on task shifting of a surgical procedure from physicians to nurses in a high-income country.

Sider (fra-til)139-144
Antal sider6
TidsskriftActa Ophthalmologica
Udgave nummer2
Tidlig onlinedato3 jul. 2019
StatusUdgivet - mar. 2020

Bibliografisk note

� 2019 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.


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