Examining the evidence base used by optometrists in Australia and New Zealand

Abstract

Background:The optometrist's role in primary eye care is expanding to include not only diagnosis but also management and co-management of a range of eye diseases and visual disorders. This role calls for evidence-based practice, including an ability to source and reliably assess the various forms of evidence, on which eye care might be based. It is not known whether optometrists registered to practise in Australasia use high or low quality evidence as a basis for their clinical decisions. Methods: The present study addressed this question by surveying 3,589 optometrists registered to practise in Australia and New Zealand. A 16-item questionnaire was made available for completion online. Results: Responses from the 279 optometrists who completed the questionnaire (response rate 7.8 per cent) indicate that, after the patient's history, symptoms and signs, optometrists in our sample place most weight on knowledge and information gained via undergraduate and postgraduate education, including continuing education, as a basis for clinical decision-making. Conclusion: These findings highlight the need for current, critically evaluated content in optometric education and suggest that optometrists currently prefer to receive information and knowledge from an educator rather than sourcing and assessing the material independently. Submitted: 7 February 2011Revised: 28 June 2011 Accepted for publication: 7 July 2011 Key words: clinical decision-making, education, evidence-based medicine, optometry, professional guidelinesOptometrists are primary eye-care providers for a large proportion of the population in Australia and elsewhere. 1 The role of the optometrist includes the prescription of a range of therapeutic drugs for ocular diseases and together with ophthalmologists optometrists share the responsibility for the management of glaucoma (at least in Australia) and other conditions. Optometrists have also taken responsibility for several other areas of eye care such as orthokeratology 2 and aspects of behavioural optometry. 3 This expanding role makes the importance of a sound basis for clinical decision-making even more apparent than it always has been, as reflected by discussions on the need for an evidencebased approach to optometry. [4][5][6][7] The importance of evidence-based practice is widely recognised in general medicine and in allied health, including eye care. 8 Despite an increasing awareness of the need for high-quality evidence as a basis for clinical decision-making, recent research indicates that in general medicine, 9,10 and at least in some areas of eye care, 11,12 research findings are not widely incorporated in clinical protocols.While the optometric profession expands its scope and assumes increasing responsibility in primary eye care for most of the population, it is important to ask about the basis of clinical decisions. The aim of the present study was to address this question by investigating the forms of evidence that are used by optometrists in METHODSA 16-item questionnaire was drafted. The d...

Utilisation of research evidence in clinical practice to improve health care delivery- practices, attitudes and challenges faced by physiotherapists in Zimbabwe: a descriptive cross sectional study

“…Several studies have reported that many physiotherapists continue to base practice decisions on knowledge obtained during their initial education and/or personal experience, rather than findings from research [10,11,17,24,25]. Although this is equally important, physiotherapists should not solely rely on this source as interventions change frequently as more research evidence is generated regarding their benefits and risks to patient care.…”

“…There is a discrepancy between the amount of research information available and its use in clinical practice ( [8,16,17],). New research findings are being published daily and practicing physiotherapists need to be in a position to utilise this information when making clinical decisions in order to deliver high quality physiotherapy services to their patients.…”

Re: The evidence in evidence‐based practice. Why the confusion?

“…EDITOR: A recent 'Viewpoint' article by Keller 1 suggests that the slow pace of uptake of evidence-based practice (EBP) in optometry compared with other allied health professions may be due to confusion around the nature of evidence in EBP and points to our paper 2 as a cause of confusion. We hope this is not the case and feel that the issue is worth further comment.…”

“…2 The sources included clinical observations (signs and symptoms) in addition to undergraduate and postgraduate training, books, journals, web sites and others. We discussed our findings in terms of the extent to which they inform clinical decisions in practice.…”

Response to Re: The evidence in evidence‐based practice. Why the confusion?

“…evidencebasedoptometry.unsw.edu.au) is an important initiative, appropriately targeted at those currently in training who will become the next generation of practitioners. I remain concerned that the project offers little more to those already in practice, based on the interpretation of the responses to the survey by Suttle, Jalbert and Alnahedh 4 and in recognition of existing access to various online evidence-based practice resources such as the Cochrane Library (http://www.thecochranelibrary. com).…”