September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Pilot Study Determining Impact of Best Practices Alerts on Hydroxychloroquine Screening Practice Patterns
Author Affiliations & Notes
  • Adrian Au
    Cleveland Clinic Foundation, Cleveland, Ohio, United States
  • Vishal Parikh
    Cleveland Clinic Foundation, Cleveland, Ohio, United States
  • Yasha Modi
    Cleveland Clinic Foundation, Cleveland, Ohio, United States
  • Justis P Ehlers
    Cleveland Clinic Foundation, Cleveland, Ohio, United States
  • Andrew Schachat
    Cleveland Clinic Foundation, Cleveland, Ohio, United States
  • Rishi P Singh
    Cleveland Clinic Foundation, Cleveland, Ohio, United States
  • Footnotes
    Commercial Relationships   Adrian Au, None; Vishal Parikh, None; Yasha Modi, None; Justis Ehlers, None; Andrew Schachat, None; Rishi Singh, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 301. doi:
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      Adrian Au, Vishal Parikh, Yasha Modi, Justis P Ehlers, Andrew Schachat, Rishi P Singh; Pilot Study Determining Impact of Best Practices Alerts on Hydroxychloroquine Screening Practice Patterns. Invest. Ophthalmol. Vis. Sci. 2016;57(12):301.

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      © 2017 Association for Research in Vision and Ophthalmology.

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Abstract

Purpose : The purpose of this study was to determine the initial impact of the best practice alert (BPA) on hydroxychloroquine (HCQ) retinopathy screening practice patterns at one multispecialty ophthalmic practice.

Methods : This was an observational, retrospective study and approval from the institutional review board was obtained. Responses and screening tests for all patients were analyzed after the implementation of a BPA in the electronic medical record (August 2015 to December 2015). Screenings were classified as: “appropriate” when an objective (SD-OCT, mfERG, FAF) and a subjective test (HVF) were performed; “under-testing” when either a 10-2 HVF or objective testing was performed; “inappropriate” if neither 10-2 HVF or objective testing was performed.

Results : Out of the 84 HCQ screening encounters that occurred after the implementation of the BPA, 57 (67.9%) were appropriately screened, 17 (20.2%) were under-screened, and 2 (2.4%) were inappropriately screened. This is in contrast to the previously described screening adherence at the same multispecialty ophthalmic practice where 54.8% were appropriately screened, 25.7% were under-screened, and 19.5% were inappropriately screened (Au et al. 2015). 10-2 HVF and SD-OCT were the preferred testing modalities at 77.6% and 93.4%, respectively.

Conclusions : Screening for HCQ retinopathy improved with the implementation of a best practice alert as appropriate screening improved from 55% to 67.9% while those inappropriately screened decreased from 19.5% to 2%.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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