Authors :
Asmaa Rjoob; Anwar Atieh
Volume/Issue :
Volume 7 - 2022, Issue 9 - September
Google Scholar :
https://bit.ly/3IIfn9N
Scribd :
https://bit.ly/3BMRhdP
DOI :
https://doi.org/10.5281/zenodo.7084193
Abstract :
To assess adherence patterns to the UK National
Institute of Health and Clinical
Excellence(NICE)guidelines on Primary COAG diagnosis
and Management(2017)in glaucoma clinics of a
Palestinian Eye Hospital.
Method
The audit was designed on randomly selected 64
primary chronic open-angle glaucoma patients from a
glaucoma clinic of the eye hospital-Palestine, who fulfilled
the inclusion criteria. Patients were divided into two
groups (New and Follow up groups), then 32 patients were
randomly selected from each group. Data were collected
retrospectively from patients' medical records. The main
outcome measures were compliance with six of the main
NICE guidelines on glaucoma diagnosis and management
(November 2017).
Results
Glaucoma clinics showed poor adherence to
guidelines regarding obtaining most of the initial
assessment investigations (central corneal thickness
gonioscopy visual field testing, and optic nerve
image , the choice of initial treatment ,
arranging appropriate monitoring intervals
whether compliance with treatment was checked (6%).
However, full adherence (100%) was seen in obtaining
applanation tonometry and disc assessment at the initial
assessment.
In general, both patient groups’ results show poor
adherence to NICEguidelines and generalization of the
clinical practice to most patients with restricted tests and
plans that have been performed and generalized. No clear
or definite local or global guideline is followed in the
practice. Therefore, appropriate policy changes and
programs to increase awareness of NICE guidelines are
recommended to improve the quality of care for glaucoma
patients and a professional performance. Re-audit should
be designed after one year of implementing the
recommended changes and improvements.
Keywords :
Primary Chronic Open-Angle Glaucoma, Diagnosis, Management, Guidelines, Clinical Audit.
To assess adherence patterns to the UK National
Institute of Health and Clinical
Excellence(NICE)guidelines on Primary COAG diagnosis
and Management(2017)in glaucoma clinics of a
Palestinian Eye Hospital.
Method
The audit was designed on randomly selected 64
primary chronic open-angle glaucoma patients from a
glaucoma clinic of the eye hospital-Palestine, who fulfilled
the inclusion criteria. Patients were divided into two
groups (New and Follow up groups), then 32 patients were
randomly selected from each group. Data were collected
retrospectively from patients' medical records. The main
outcome measures were compliance with six of the main
NICE guidelines on glaucoma diagnosis and management
(November 2017).
Results
Glaucoma clinics showed poor adherence to
guidelines regarding obtaining most of the initial
assessment investigations (central corneal thickness
gonioscopy visual field testing, and optic nerve
image , the choice of initial treatment ,
arranging appropriate monitoring intervals
whether compliance with treatment was checked (6%).
However, full adherence (100%) was seen in obtaining
applanation tonometry and disc assessment at the initial
assessment.
In general, both patient groups’ results show poor
adherence to NICEguidelines and generalization of the
clinical practice to most patients with restricted tests and
plans that have been performed and generalized. No clear
or definite local or global guideline is followed in the
practice. Therefore, appropriate policy changes and
programs to increase awareness of NICE guidelines are
recommended to improve the quality of care for glaucoma
patients and a professional performance. Re-audit should
be designed after one year of implementing the
recommended changes and improvements.
Keywords :
Primary Chronic Open-Angle Glaucoma, Diagnosis, Management, Guidelines, Clinical Audit.