Primary Care Provider Familiarity and Compliance With Preferred Practice Patterns for Comprehensive Eye Examinations

Area of Science:

• Ophthalmology
• Primary Care Medicine
• Health Services Research

Background:

• Primary care practitioners (PCPs) play a vital role in initial patient screening and referrals for comprehensive eye examinations (CEEs).
• Familiarity with American Academy of Ophthalmology (AAO) Preferred Practice Pattern (PPP) guidelines for CEEs is essential for appropriate patient management.
• Gaps in PCP knowledge can lead to delayed or unnecessary eye care.

Purpose of the Study:

• To assess primary care practitioners' (PCPs) familiarity with AAO PPP guidelines regarding the frequency of comprehensive eye examinations (CEEs).
• To explore PCPs' opinions and practices concerning patient counseling and referrals for CEEs.
• To identify factors influencing PCP adherence to CEE guidelines.

Main Methods:

• A cross-sectional study design was employed.
• Anonymous surveys were distributed to MD, DO, PA, and NP clinicians and residents at two major hospitals between February and June 2019.
• Descriptive statistics were used to analyze survey responses regarding guideline awareness, patient counseling, and referral practices.

Main Results:

• A significant portion of PCPs (63.9%) were unaware of AAO CEE guidelines, and only 11.1% could describe them.
• Counseling rates for CEEs varied, with 36.5% of PCPs seldom or never counseling patients.
• While most PCPs correctly referred type 2 diabetic patients, premature referrals occurred for type 1 diabetics, and delays were noted for patients with a family history of glaucoma.

Conclusions:

• PCP awareness of and familiarity with AAO CEE guidelines are inconsistent and appear to improve with provider age and experience.
• Targeted educational interventions may be most effective for residents and mid-level practitioners (PAs/NPs) to enhance guideline adherence.
• Improving PCP knowledge is critical for optimizing the timing and appropriateness of comprehensive eye examinations.