الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 98 |  |  |
| | | from | 98 | | |
Abstract
Adherence to guidelines offers the chance to improve clinical outcomes and quality
of care provided to patients by reducing practice variation. Due to changes in research
findings and recently available diagnostic and therapeutic interventions, guidelines should
be assessed for validity and updated on a regular basis.
Increasing efforts are being taken to implement guidelines but some factors hinder
physicians from adopting them including lack of financial resources, deficient physicians’
knowledge about guidelines and their training on them.
Aim of the study:
To study physicians’ adherence to guidelines of the International Council of
Ophthalmology (ICO) in initial evaluation of primary open angle glaucoma patients in
Alexandria General Eye Hospital, Egypt.
Target population and study sample:
A cross-sectional analytical study design was conducted on all physicians attending the
outpatient clinics of Alexandria General Eye Hospital, Egypt (around 70) and all medical
records of primary open angle glaucoma patients who were examined by these physicians
during their initial visit.
Data collection methods and tools:
1. A checklist was developed by the international council of ophthalmology is used to
record the adherence of the assigned physician to the stated guidelines and to review
medical records of patients diagnosed with primary open angle glaucoma.
2. A Self-administered questionnaire is presented to the observed physicians to discover
their opinions about important issues related to the present study
The results of the present study revealed the following:
More than one third of ophthalmologists did not know about the presence of
glaucoma guidelines in the first place. More than half of ophthalmologists are not
committed to guidelines while managing glaucoma patients. Most of
ophthalmologists rely only on their own experience in glaucoma management.
Most of ophthalmologists found standardization of glaucoma practice and specially
the ICO guidelines is either excellent or very good.
A great discrepancy detected between the performed examination and the
documented results by ophthalmologists. More than three fourths ophthalmologists
do not document their examination results in medical records.
Most of examination processes observed either directly or through medical records
were not adherent to the ICO glaucoma guidelines.
The major barriers that hinder the application of ICO glaucoma guidelines were lack
of financial and scientific resources.
There were statistically significant relations between ophthalmologists’ job title and
years of experience on a hand and adherence to glaucoma guidelines in general on
the other hand. Another statistically significant relation between ophthalmologists’
qualifications, job title and years of experience on a hand and level of adherence to
ICO glaucoma guidelines specifically on the other hand.
The following recommendations were suggested:
1. Recommendations for Alexandria Faculty of Medicine:
The concept of standardization should be integrated in the under and post-graduate
medical curriculum.
Training on the use of guidelines should be provided to house officers.
2. Recommendations for Ministry of Health and Population:
Policies should be developed to introduce the ICO glaucoma guidelines as a national
reference, apply regular training programs on the use of these guidelines and
regularly audit the examination process.
Instruments required by the guidelines should be provided.
3. Recommendations for Alexandria General Eye Hospital:
Reporting difficulties that face the application or adherence to ICO glaucoma
guidelines to authorities.
Improving documentation practices and providing ophthalmologists with regular
training programs. .
4. Recommendations for further research:
Apply similar studies on the application of ICO guidelines in other ophthalmic
diseases and other healthcare sectors as university, health insurance and military
hospitals.