Compliance with Primary Open-Angle Glaucoma and Primary Open-Angle Glaucoma Suspect Preferred Practice Patterns in a Retail-Based Eye Clinic

Details

• Alternative Title:
  J Glaucoma
• Personal Author:
  Stanley, Jordan ; Huisingh, Carrie E. ; Swain, Thomas A. ; McGwin, Gerald ; Owsley, Cynthia ; Girkin, Christopher A. ; Rhodes, Lindsay A.
• Description:
  Purpose:
  
  To determine the level of adherence to the American Academy of Ophthalmology (AAO) preferred practice pattern (PPP) guidelines for quality primary open angle glaucoma (POAG) and POAG suspect (POAGS) care among retail-based optometrists.
  
  Methods:
  
  Patients with a diagnosis of POAG or POAGS who participated in a telemedicine pilot project were included. Patients’ charts were evaluated for 15 elements of PPP guidelines for glaucoma care. Results were further stratified by number of follow-up visits and diagnosis.
  
  Results:
  
  Of 360 identified patients, ten elements were documented in over 98%. Documentation of the remaining five components was as follows: dilated fundus exam (DFE) 91.1%, central corneal thickness (CCT) 88.6%, visual field 78.9%, gonioscopy 47.5%, and target intraocular pressure (IOP) 15.6%. 32.8% of patients were seen once while the remaining 67.2% had multiple visits. In patients with multiple visits, providers were more likely to document systemic history (100.0% versus 97.5%, P=0.0346), review of systems (100.0% v. 97.5%, P=0.0346), gonioscopy (60.0% v. 22.0%, P<0.001), CCT (94.2% v. 77.1%, P<0.001), visual field (97.5% v. 40.7%, P<0.001), and target IOP (22.4% v. 1.7%, P<0.001) compared to single visit patients. In stratifying results by diagnosis, POAG patients more often received visual field testing (92.7% v. 68.9%, P<0.001) and had an established target IOP (35.1% v. 1.4%, P<0.001) compared to POAGS patients.
  
  Conclusions:
  
  Compliance with PPP guidelines for glaucoma care was very high for most elements but lower for performing DFE, CCT, visual field, gonioscopy, and target IOP. This study highlights deficiencies in care likely to hamper the detection of glaucoma progression.
  
  
• Subjects:
  Academies And Institutes Aged Ambulatory Care Facilities Article Female Glaucoma, Open-Angle Gonioscopy Guideline Adherence Humans Intraocular Pressure Male Middle Aged Ocular Hypertension Ophthalmology Optometrists Optometry Patient Compliance Physical Examination Pilot Projects Practice Patterns, Physicians' Preferred Practice Pattern Primary Open-angle Glaucoma Primary Open-angle Glaucoma Suspect Retail-based Eye Clinic Tonometry, Ocular Visual Fields Visual Field Tests

  More +
• Source:
  J Glaucoma. 27(12):1068-1072
• Pubmed ID:
  30234750
• Pubmed Central ID:
  PMC6265080
• Document Type:
  Journal Article
• Funding:
  K23 EY025724/EY/NEI NIH HHS/United States ; U58 DP004061/DP/NCCDPHP CDC HHS/United States
• Volume:
  27
• Issue:
  12
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:ae48d9568bb27b06be43ab3221da33cbb25c992be249b915c5734699ef4dc3ae
• Download URL:
  https://stacks.cdc.gov/view/cdc/61018/cdc_61018_DS1.pdf
• File Type:
  [PDF - 68.97 KB ]