Agreement in dry eye management between optometrists and general practitioners in primary health care in the Netherlands. Issue 4 (August 2015)

• Record Type: Journal Article
• Authors: van Tilborg, M.M.A.; Murphy, Paul J.; Evans, K.S.E.
• Is Part Of: Contact lens & anterior eye. Volume 38:Issue 4(2015)
• Page Start: 283
• Page End: 293
• Publication Date: 2015-08
• Subjects: Dry eye disease -- Optometric care -- GPs' -- Primary healthcare -- Investigation techniques -- Co-management; Anterior segment (Eye) -- Periodicals; Contact lenses -- Periodicals; Segment antérieur (Œil) -- Périodiques; Lentilles de contact -- Périodiques; 617.752305
• DOI: 10.1016/j.clae.2015.03.005
• Languages: English
• ISSNs: 1367-0484

Abstract

Highlights: This is the first study to investigate diagnosis and management of dry eye between general practitioners and optometrists in the Netherlands. There is virtually no agreement for all questions with the exception that symptoms of 'burning' and 'irritation' of the eye and that dry eye is an age-related disease. The significant variance in diagnosis and management between practitioners may have a detrimental impact on the consistency of patient care. The development of management pathways and co-management is likely to reduce the significant burden of dry eye management to the Dutch healthcare system. Abstract: Purpose: To investigate the agreement in dry eye care management between general practitioners (GPs) and optometrists in the Netherlands. Methods: A web-based survey was used to investigate the agreement in symptoms associated with dry eye, causes of developing dry eye, and investigative techniques used in practice, between GPs and optometrists. Additional questions surveyed knowledge of the latest research, and co-management of dry eye disease in primary healthcare. The anonymised questionnaire contained 16 forced-choice questions with Likert scales, and was sent to 1471 general medical practitioners and 870 registered optometrists. The response data was stored on an online database, and was converted directly to text format for analysis using SPSS 21 statistical analysis software. Results: 138 optometrists and 93 GPs responded to the survey (Cronbach α = 0.885, optometrists, and 0.833, GPs). Almost no agreement was found for all the questions: a statistically significant difference (Chi-square p < 0.0001) was found between the optometrists and GPs in the use of investigative techniques, associating symptoms, causes of dry eye ( p > 0.0001), and dry eye symptoms, except for 'burning sensation of the eye' and 'irritation of the eye' as agreed symptoms, and agreement that dry eye is an age-related disease. Conclusions: As the optometrist and the GP are the gatekeepers for secondary healthcare, the fundamental differences in the methods of investigation and interpretation of dry eye-related symptoms, the possible cause of developing dry eye disease, and the therapy given by GPs and optometrists in the Netherlands, may have a significant impact on consistency of patient care.