Primary Care Provider Familiarity and Compliance with Preferred Practice Patterns for Comprehensive Eye Examinations. Am J Ophthalmol 2022;Abstract.
PURPOSE: To assess primary care practitioners' (PCPs) familiarity with American Academy of Ophthalmology Preferred Practice Pattern (PPP) guidelines on the frequency of comprehensive eye examinations (CEEs) and explore their opinions and practices on counseling and referring patients for CEEs. DESIGN: Cross-sectional study. METHODS: Between February 1, 2019, and June 25, 2019, an anonymous survey was emailed to clinicians holding an MD, DO, PA, or NP degree, and residents at Brigham and Women's Hospital and University of Oklahoma. Descriptive statistics of participants' responses were reported. RESULTS: Regarding patient counseling on CEEs, 15.4% of PCPs reported "always", 48.1% "usually", and 36.5% "seldom" or "never" doing so. Few PCPs (11.1%) reported able to describe the guidelines and 63.9% were unaware of their existence. A strong majority of PCPs (90.7%) correctly referred a type 2 diabetic at their time of diagnosis, but a similar majority (77.8%) prematurely referred a newly-diagnosed type 1 diabetic. One in 7 (13.4%) PCPs would refer a patient with family history of glaucoma only upon developing visual/ocular symptoms. Compared to other providers, PAs/NPs were more likely to recommend unnecessary CEEs for low-risk individuals (p=0.009), while residents counseled patients less frequently (p=0.003), were less likely to be familiar with PPP guidelines (p=0.026), and less likely to recommend appropriate follow-ups for patients with family history of glaucoma (p=0.004). CONCLUSIONS: PCPs' awareness and familiarity with AAO CEE guidelines is variable and improves with provider age and experience. Efforts to improve PCP guideline awareness may be especially well-suited for residents and mid-level practitioners.