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Abstract：
Since the introduction of National Institute for Health and Care Excellence glaucoma guidelines 2009, the number of referrals from community optometrists to hospital eye services has increased across the UK, resulting in increase in first visit discharge rates (FVDRs).
To assess the impact of Scottish Intercollegiate Guidelines Network (SIGN) 144 on quality of referrals from community optometrists.
A retrospective study of patient records who attended as new adult glaucoma referrals to clinics in Princess Alexandra Eye Pavilion, Edinburgh, and in Greater Glasgow and Clyde, was carried out across October-November 2014 (group 1) and September-October 2016 (group 2), before and after the introduction of SIGN 144. The primary outcome of this study is FVDRs. A secondary outcome is the extent of compliance to referral recommendations by SIGN guidelines.
Three hundred and twelve and 325 patients were included in groups 1 and 2, respectively. There was a significant decline in FVDRs between these two periods from 29.2% to 19.2%. ( p=0.004) (OR 0.58 (95%CI 0.40 to 0.84)). Post-SIGN guidelines, 87% of referrals were compliant to SIGN referral criteria while 13% remained non-compliant. The main reasons for non-compliance were no repeatable visual field defects (42.0%) and referrals due to high intraocular pressure were either not repeated or not interpreted in the context of age and central corneal thickness (36.8%).
Patients referred after the introduction of SIGN guidelines were 33.5% less likely to be discharged at the first visit. Although compliance to most recommendations in SIGN guidelines has improved, there is still a need to improve adherence to referral criteria.
To assess the impact of Scottish Intercollegiate Guidelines Network (SIGN) 144 on quality of referrals from community optometrists.
A retrospective study of patient records who attended as new adult glaucoma referrals to clinics in Princess Alexandra Eye Pavilion, Edinburgh, and in Greater Glasgow and Clyde, was carried out across October-November 2014 (group 1) and September-October 2016 (group 2), before and after the introduction of SIGN 144. The primary outcome of this study is FVDRs. A secondary outcome is the extent of compliance to referral recommendations by SIGN guidelines.
Three hundred and twelve and 325 patients were included in groups 1 and 2, respectively. There was a significant decline in FVDRs between these two periods from 29.2% to 19.2%. ( p=0.004) (OR 0.58 (95%CI 0.40 to 0.84)). Post-SIGN guidelines, 87% of referrals were compliant to SIGN referral criteria while 13% remained non-compliant. The main reasons for non-compliance were no repeatable visual field defects (42.0%) and referrals due to high intraocular pressure were either not repeated or not interpreted in the context of age and central corneal thickness (36.8%).
Patients referred after the introduction of SIGN guidelines were 33.5% less likely to be discharged at the first visit. Although compliance to most recommendations in SIGN guidelines has improved, there is still a need to improve adherence to referral criteria.
摘要：
自2009年国家健康与护理卓越青光眼指南出台以来，英国各地从社区验光师转诊到医院眼科服务的人数有所增加，导致首次就诊出院率（FVDR）增加。
评估苏格兰校际指南网络（SIGN）144对社区验光师推荐质量的影响。
在亚历山德拉公主眼馆就诊的新成人青光眼转诊的患者记录的回顾性研究，爱丁堡,在大格拉斯哥和克莱德，在2014年10月至11月（第1组）和2016年9月至10月（第2组）进行，在引入144号之前和之后。这项研究的主要结果是FVDR。次要结果是SIGN指南对转诊建议的遵守程度。
第1组和第2组分别包括三百十二名和325名患者。在这两个时期之间，FVDR从29.2%显著下降到19.2%。（p=0.004）（OR0.58（95CI0.40至0.84））。后标志指引，87％的转诊者符合SIGN转诊标准，而13％的转诊者仍不符合。不遵守的主要原因是没有可重复的视野缺陷（42.0％），并且由于高眼压引起的转诊在年龄和中央角膜厚度的背景下没有重复或没有解释（36.8％）。
引入SIGN指南后转诊的患者在首次就诊时出院的可能性降低了33.5％。尽管遵守SIGN指南中的大多数建议的情况有所改善，仍然需要提高对转诊标准的遵守程度.
评估苏格兰校际指南网络（SIGN）144对社区验光师推荐质量的影响。
在亚历山德拉公主眼馆就诊的新成人青光眼转诊的患者记录的回顾性研究，爱丁堡,在大格拉斯哥和克莱德，在2014年10月至11月（第1组）和2016年9月至10月（第2组）进行，在引入144号之前和之后。这项研究的主要结果是FVDR。次要结果是SIGN指南对转诊建议的遵守程度。
第1组和第2组分别包括三百十二名和325名患者。在这两个时期之间，FVDR从29.2%显著下降到19.2%。（p=0.004）（OR0.58（95CI0.40至0.84））。后标志指引，87％的转诊者符合SIGN转诊标准，而13％的转诊者仍不符合。不遵守的主要原因是没有可重复的视野缺陷（42.0％），并且由于高眼压引起的转诊在年龄和中央角膜厚度的背景下没有重复或没有解释（36.8％）。
引入SIGN指南后转诊的患者在首次就诊时出院的可能性降低了33.5％。尽管遵守SIGN指南中的大多数建议的情况有所改善，仍然需要提高对转诊标准的遵守程度.
