Clinical indicators for diabetic eyecare delivered by optometrists in Australia: a Delphi study.
| Autor: | Gyawali R; School of Optometry and Vision Science, UNSW Sydney, Sydney, New South Wales, Australia., Toomey M; School of Optometry and Vision Science, UNSW Sydney, Sydney, New South Wales, Australia., Stapleton F; School of Optometry and Vision Science, UNSW Sydney, Sydney, New South Wales, Australia., Ho KC; School of Optometry and Vision Science, UNSW Sydney, Sydney, New South Wales, Australia., Keay L; School of Optometry and Vision Science, UNSW Sydney, Sydney, New South Wales, Australia., Pye DC; School of Optometry and Vision Science, UNSW Sydney, Sydney, New South Wales, Australia., Katalinic P; School of Optometry and Vision Science, UNSW Sydney, Sydney, New South Wales, Australia., Liew G; Centre for Vision Research, Westmead Institute for Medical Research, Sydney, New South Wales, Australia., Hsing YI; Department of Optometry, Okko Eye Specialist Centre, Upper Mount Gravatt, Queensland, Australia., Ramke J; School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand., Gentle A; School of Medicine, Deakin University, Geelong, Victoria Australia., Webber AL; Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia., Schmid KL; Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia., Bentley S; Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia., Hibbert P; Australian Institute of Health Innovation, Macquarie University, Sydney, Australia., Wiles L; Australian Institute of Health Innovation, Macquarie University, Sydney, Australia., Jalbert I; School of Optometry and Vision Science, UNSW Sydney, Sydney, New South Wales, Australia. |
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| Jazyk: | angličtina |
| Zdroj: | Clinical & experimental optometry [Clin Exp Optom] 2024 Jul; Vol. 107 (5), pp. 571-580. Date of Electronic Publication: 2023 Oct 17. |
| DOI: | 10.1080/08164622.2023.2253792 |
| Abstrakt: | Clinical Relevance: Valid and updated clinical indicators can serve as important tools in assessing and improving eyecare delivery. Background: Indicators for diabetic eyecare in Australia were previously developed from guidelines published before 2013 and then used to assess the appropriateness of care delivery through a nationwide patient record card audit (the iCareTrack study). To reflect emerging evidence and contemporary practice, this study aimed to update clinical indicators for optometric care for people with type 2 diabetes in Australia. Methods: Forty-five candidate indicators, including existing iCareTrack and new indicators derived from nine high-quality evidence-based guidelines, were generated. A two-round modified Delphi process where expert panel members rated the impact, acceptability, and feasibility of the indicators on a 9-point scale and voted for inclusion or exclusion of the candidate indicators was used. Consensus on inclusion was reached when the median scores for impact, acceptability, and feasibility were ≥7 and >75% of experts voted for inclusion. Results: Thirty-two clinical indicators with high acceptability, impact and feasibility ratings (all median scores: 9) were developed. The final indicators were related to history taking ( n = 12), physical examination ( n = 8), recall period ( n = 5), referral ( n = 5), and patient education/communication ( n = 2). Most (14 of 15) iCareTrack indicators were retained either in the original format or with modifications. New indicators included documenting the type of diabetes, serum lipid level, pregnancy, systemic medications, nephropathy, Indigenous status, general practitioner details, pupil examination, intraocular pressure, optical coherence tomography, diabetic retinopathy grading, recall period for high-risk diabetic patients without retinopathy, referral of high-risk proliferative retinopathy, communication with the general practitioner, and patient education. Conclusion: A set of 32 updated diabetic eyecare clinical indicators was developed based on contemporary evidence and expert consensus. These updated indicators inform the development of programs to assess and enhance the eyecare delivery for people with diabetes in Australia. |
| Databáze: | MEDLINE |
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