title: Primary care physicians' role perception and self-reported performance in glaucoma care: a survey study.
abstract: BACKGROUND
  Glaucoma is a leading cause of blindness. The participation of primary care physicians (PCPs) in glaucoma care may improve health outcomes for glaucoma patients.
  
  
  OBJECTIVE
  To investigate PCPs' attitudes towards their role in glaucoma care, perceived barriers, and self-reported performance in glaucoma management.
  
  
  METHODS
  PCPs working in the Haifa and Western Galilee District of Clalit Health Services, Israel's largest Health Maintenance Organization (HMO) were asked to complete a self-administered structured questionnaire. Physicians were asked to rate their agreement with statements describing the PCP's role in glaucoma care, and to state how often they behave accordingly in their practice. In addition, physicians were asked to rate the extent that factors such as time constraints and knowledge gaps impede their performance in glaucoma care.
  
  
  RESULTS
  Eighty-two physicians completed the questionnaire. The majority thought that PCPs have a major role in early detection of glaucoma (99 %), discussing the importance of adherence to treatment (93 %), and encouraging patients to make regular visits to their ophthalmologist (99 %). However, only 30 % reported asking patients about family history of glaucoma, 64 % reported discussing adherence to treatment, and only 35 % stated that they explain how to use eye drops, while most of respondents (87 %) regularly provide refill prescriptions for glaucoma medications. Sixty percent claimed that during their residency they had not acquired adequate knowledge and competence to allow them to take proper care of glaucoma patients. The main barriers reported were lack of time (43 %), lack of knowledge regarding treatment options and recommended follow-up (46 %), and not being familiar with glaucoma medications' side effects (54 %).
  
  
  CONCLUSIONS
  There is a gap between PCPs' perceptions of their role in glaucoma care and their report on actual performance in early detection and management of glaucoma. Further research is needed to develop and assess interventions that aim at closing this gap.
authors.affiliation: Department of Family Medicine, Clalit Health Services, Haifa and Western Galilee, Israel. albinart@gmail.com.|Division of Family Medicine, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. albinart@gmail.com.
authors.forename: Albina
authors.initials: A
authors.lastname: Rotshtein
authors.affiliation: Department of Family Medicine, Clalit Health Services, Haifa and Western Galilee, Israel. khaledka@clalit.org.il.|Division of Family Medicine, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. khaledka@clalit.org.il.
authors.forename: Khaled
authors.initials: K
authors.lastname: Karkabi
authors.affiliation: Department of Ophthalmology, Rappaport Faculty of Medicine, Carmel Medical Center, The Technion-Israel Institute of Technology, Haifa, Israel. drgo@netvision.net.il.
authors.forename: Orna
authors.initials: O
authors.lastname: Geyer
authors.affiliation: Division of Family Medicine, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. hforitco@gmail.com.|The Cheryl Spencer Department of Nursing, University of Haifa, Haifa, Israel. hforitco@gmail.com.
authors.forename: Orit
authors.initials: O
authors.lastname: Cohen Castel
mesh_terms: D000328:Adult; D002983:Clinical Competence; D005260:Female; D005901:Glaucoma / Q000628:therapy*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007557:Israel; D008297:Male; D008875:Middle Aged; D010819:Physician's Role; D058007:Physicians, Primary Care / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires