Primary Care Physicians' Eye Care Practice: Evaluating physicians' knowledge, perception, and practice in eye care

Abstract

Purpose : Primary care physicians (PCPs) play an important role in preventing and managing eye disorders^1,2. Many studies reported inconsistencies in PCPs’ eye care practices^1,3-4, recognizing potential negative impacts on patient care. This study examined PCPs’ knowledge, awareness, and perceptions of eye care guidelines and how it relates to practice patterns.

Methods : The questionnaire was distributed to Canadian PCPs and collected: (i)demographics; (ii)guideline awareness, perspectives, and use; and (iii) practice patterns.

Results : 51 PCPs participated, including family physicians (94.1%), internists (2.0%) and geriatricians (3.9%). Physicians were practicing 0-49 years, with 53.06% >20 years, in a private office (78.4%), teaching (15.6%) or community hospital (11.8%), and/or university clinic (3.9%).

40.8% of PCPs were aware of practice guidelines, including the American Academy of Ophthalmology (2.0%), American Academy of Family Physicians (AAFP) (4.8%), College of Family Physicians of Canada (CFPC) (25.5%), Canadian Ophthalmology Society (COS) (7.8%). Fewer physicians used guidelines, specifically the AAFP (2.0%), CFPC (19.6%), COS (5.9%). 20.4% of PCPs claimed existing guidelines altered their practice, while 79.6% claimed recommendations did not alter their practice or did not use guidelines. 58.3% of PCPs believed Canadian guidelines could alter their practice. Barriers to implementation included lack of training, administrative support, time, finances, equipment, and forgetting.

PCP practices included preventing (72.0%), screening (48.0%), diagnosing (42.0%), treating (76%; 6.0%), and managing (65%; 16%) acute and chronic eye diseases, referrals to optometry (92.0%) or ophthalmology (98.0%), and/or education (48%). PCPs screened for disorders such as red-eye (80.0%), glaucoma (2.0%), diabetic retinopathy (38.0%), and/or cataracts (28.0%), based on self-reported symptoms (94.1%), history (88.2%), risk factors (54.9%), examination (41.2%), visual acuity (68.6%), visual fields (37.3%), and/or ophthalmoscopy (41.2%)

Conclusions : PCPs have a wide scope of practice related to eye disorders. Although guidelines exist to support practices, many PCPs were not aware and/or did not use these recommendations. Despite barriers, Canadian primary care guidelines could alter clinical practice and reduce inconsistencies in care.

This is a 2020 ARVO Annual Meeting abstract.