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«Do Not Do» recommendations for retinopathies: A mixed consensus study.

L Pablo¹, C A Beckford², J Martin-Delgado³

¹Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España; OFTARED, Universidad de Zaragoza, Zaragoza, España.

Archivos De La Sociedad Espanola De Oftalmologia

|February 22, 2021

Summary

This summary is machine-generated.

This study identified low-value care practices, or "Do Not Do" recommendations, for common causes of vision loss. These practices occur frequently, highlighting a need to improve healthcare processes and patient outcomes.

Keywords:

Aseguramiento de la calidad Degeneración macular Diabetic eye disease Edema macular diabético Low-value practice Macular degeneration Oclusión venosa de la retina Patient safety Quality assurance Retinal vein occlusions Right care Seguridad del paciente

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Area of Science:

Ophthalmology
Health Services Research

Background:

Age-related macular degeneration, diabetic macular edema, and retinal vein occlusion are leading causes of vision impairment.
"Do Not Do" recommendations aim to enhance care quality and manage healthcare costs.

Purpose of the Study:

To establish consensus on low-value practices for major retinal pathologies.
To estimate the occurrence of these "Do Not Do" recommendations in clinical practice.

Main Methods:

A mixed-methods approach combining expert consensus (Nominal Group technique) and retrospective medical record review.
Multidisciplinary expert panel involved in consensus building.
Analysis of 1,012 medical records from four hospitals.

Main Results:

Seven "Do Not Do" recommendations for age-related macular degeneration, four for diabetic macular edema, and five for retinal vein occlusion were established.
The occurrence of agreed-upon "Do Not Do" practices ranged from 0.6% to 31.4% in the reviewed cases.
Significant variation in the frequency of low-value practices across different conditions was observed.

Conclusions:

The study identified "Do Not Do" recommendations that are prevalent in clinical practice for these vision-threatening conditions.
There is a clear need to revise healthcare processes to eliminate these low-value practices.
Implementing changes can lead to improved quality of care for patients with retinal diseases.