Literature DB >> 32777008

Practice Patterns and Responsiveness to Simulated Common Ocular Complaints Among US Ophthalmology Centers During the COVID-19 Pandemic.

Matthew R Starr1, Rachel Israilevich2, Michael Zhitnitsky3, Qianqian E Cheng1, Rebecca R Soares1, Luv G Patel1, Michael J Ammar1, M Ali Khan1, Yoshihiro Yonekawa1, Allen C Ho1, Michael N Cohen1, Jayanth Sridhar4, Ajay E Kuriyan1.   

Abstract

IMPORTANCE: The coronavirus disease 2019 (COVID-19) pandemic has drastically changed how comprehensive ophthalmology practices care for patients.
OBJECTIVE: To report practice patterns for common ocular complaints during the initial stage of the COVID-19 pandemic among comprehensive ophthalmology practices in the US. DESIGN, SETTING, AND PARTICIPANTS: In this cross-sectional study, 40 private practices and 20 university centers were randomly selected from 4 regions across the US. Data were collected on April 29 and 30, 2020.
INTERVENTIONS: Investigators placed telephone calls to each ophthalmology practice office. Responses to 3 clinical scenarios-refraction request, cataract evaluation, and symptoms of a posterior vitreous detachment-were compared regionally and between private and university centers. MAIN OUTCOMES AND MEASURES: The primary measure was time to next appointment for each of the 3 scenarios. Secondary measures included use of telemedicine and advertisement of COVID-19 precautions.
RESULTS: Of the 40 private practices, 2 (5%) were closed, 24 (60%) were only seeing urgent patients, and 14 (35%) remained open to all patients. Of the 20 university centers, 2 (10%) were closed, 17 (85%) were only seeing urgent patients, and 1 (5%) remained open to all patients. There were no differences for any telemedicine metric. University centers were more likely than private practices to mention preparations to limit the spread of COVID-19 (17 of 20 [85%] vs 14 of 40 [35%]; mean difference, 0.41; 95% CI, 0.26-0.65; P < .001). Private practices had a faster next available appointment for cataract evaluations than university centers, with a mean (SD) time to visit of 22.1 (27.0) days vs 75.5 (46.1) days (mean difference, 53.4; 95% CI, 23.1-83.7; P < .001). Private practices were also more likely than university centers to be available to see patients with flashes and floaters (30 of 40 [75%] vs 8 of 20 [40%]; mean difference, 0.42; 95% CI, 0.22-0.79; P = .01). CONCLUSIONS AND RELEVANCE: In this cross-sectional study of investigator telephone calls to ophthalmology practice offices, there were uniform recommendations for the 3 routine ophthalmic complaints. Private practices had shorter times to next available appointment for cataract extraction and were more likely to evaluate posterior vitreous detachment symptoms. As there has not been a study examining these practice patterns before the COVID-19 pandemic, the relevance of these findings on public health is yet to be determined.

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Mesh:

Year:  2020        PMID: 32777008      PMCID: PMC7407319          DOI: 10.1001/jamaophthalmol.2020.3237

Source DB:  PubMed          Journal:  JAMA Ophthalmol        ISSN: 2168-6165            Impact factor:   7.389


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