A Scoping Review of Process Indicators for Measuring Quality of Care in Glaucoma.

Iorio-Aranha, Flavio; Peleteiro, Bárbara; Rocha-Sousa, Amândio; Azevedo, Ana; Breda, João Barbosa

PRCIS There are no standardized process quality indicators in glaucoma care. Although they can be inferred from guidelines and trials, they should be designed and standardized to allow better assessment of the quality of care. PURPOSE Quality indicators are crucial for assessing the performance of any health care system. To allow efficiency, effectiveness, and patient-centeredness, there is a need for prompt acquisition of up-to-date information. Among the available quality indicators, process indicators have the highest sensitivity to frequent changes and could better reflect the implementation outcomes of novel ideas and technology. This study aimed to map the available information regarding process quality indicators in glaucoma care, identify the current development stage of these indicators, and systematically synthesize them. METHODS We performed a scoping review of four electronic bibliographic databases for studies reporting on process quality indicators in glaucoma. We retrieved 7502 references and created a domain list reflecting the core idea underlying each indicator. RESULTS We summarized information from 18 documents and listed 20 domains. The most mentioned domains were follow-up, optic nerve head assessment, visual field test, and intra-ocular pressure. Indicators regarding quality of life assessment, patient assistance, or presence of written protocols were less frequently mentioned. CONCLUSION There are notable variations among process quality indicators in glaucoma and significant heterogeneity in their descriptions in published studies. Although novel indicators can be inferred from guidelines and trials, they should be designed and standardized for better assessment of performance in health systems to improve their quality.