June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Clinical indicators for assessment of optometric diabetic eyecare in Australia
Author Affiliations & Notes
  • Rajendra Gyawali
    Optometry and Vision Science, UNSW Sydney, Sydney, New South Wales, Australia
    Better Vision Foundation Nepal, Kathmandu, Bagmati, Nepal
  • Melinda Toomey
    Optometry and Vision Science, UNSW Sydney, Sydney, New South Wales, Australia
  • Fiona Stapleton
    Optometry and Vision Science, UNSW Sydney, Sydney, New South Wales, Australia
  • Kam Chun Ho
    Optometry and Vision Science, UNSW Sydney, Sydney, New South Wales, Australia
    Discipline of Optometry and Vision Science, University of Canberra, Canberra, Australian Capital Territory, Australia
  • Lisa Keay
    Optometry and Vision Science, UNSW Sydney, Sydney, New South Wales, Australia
  • Alex Gentle
    School of Medicine, Faculty of Health, Deakin University, Geelong, Victoria, Australia
  • Ann Louise Webber
    Centre for Vision and Eye Research, Queensland University of Technology Faculty of Health, Kelvin Grove, Queensland, Australia
  • David Cecil Pye
    Optometry and Vision Science, UNSW Sydney, Sydney, New South Wales, Australia
  • Gerald Liew
    Westmead Institute for Medical Research, Sydney, New South Wales, Australia
    Optometry and Vision Science, UNSW Sydney, Sydney, New South Wales, Australia
  • Yan Inez Hsing
    Okko Eye Specialist Centre, Queensland, Australia
  • Jacqueline Ramke
    London School of Hygiene and Tropical Medicine International Centre for Eye Health, London, London, United Kingdom
    School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
  • Katrina L Schmid
    Centre for Vision and Eye Research, Queensland University of Technology Faculty of Health, Kelvin Grove, Queensland, Australia
  • Paula Katalinic
    Optometry and Vision Science, UNSW Sydney, Sydney, New South Wales, Australia
  • Sharon Bentley
    Centre for Vision and Eye Research, Queensland University of Technology Faculty of Health, Kelvin Grove, Queensland, Australia
  • Isabelle Jalbert
    Optometry and Vision Science, UNSW Sydney, Sydney, New South Wales, Australia
  • Footnotes
    Commercial Relationships   Rajendra Gyawali None; Melinda Toomey None; Fiona Stapleton None; Kam Chun Ho None; Lisa Keay None; Alex Gentle None; Ann Webber None; David Pye None; Gerald Liew None; Yan Inez Hsing None; Jacqueline Ramke None; Katrina Schmid None; Paula Katalinic None; Sharon Bentley None; Isabelle Jalbert None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 2785 – A0115. doi:
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      Rajendra Gyawali, Melinda Toomey, Fiona Stapleton, Kam Chun Ho, Lisa Keay, Alex Gentle, Ann Louise Webber, David Cecil Pye, Gerald Liew, Yan Inez Hsing, Jacqueline Ramke, Katrina L Schmid, Paula Katalinic, Sharon Bentley, Isabelle Jalbert; Clinical indicators for assessment of optometric diabetic eyecare in Australia. Invest. Ophthalmol. Vis. Sci. 2022;63(7):2785 – A0115.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Clinical indicators for diabetic eyecare were previously developed from clinical guidelines published before 2013 and were tested in a nationwide patient record card audit (iCareTrack study), to assess the appropriateness of optometric diabetic eyecare delivery in Australia. To reflect emerging evidence, updated guidelines, and contemporary optometry practice, this study aimed to update the diabetic eyecare clinical indicators.

Methods : Candidate indicators included existing iCareTrack and new indicators derived from nine high-quality evidence-based guidelines identified through a systematic review. A two-round modified Delphi process with an expert panel (eight optometrists and one ophthalmologist) was used for consensus on the candidate indicators. In round-1, the experts rated the impact, acceptability, and feasibility of the indicators on a 9-point scale and voted for inclusion or exclusion. Consensus on inclusion was defined when the median scores for impact, acceptability, and feasibility were ≥7 and >75% of experts voted for inclusion. Any indicator that failed to reach consensus was presented for re-evaluation in round-2, with updated evidence summaries, de-identified group feedback and any modification suggestions from round-1.

Results : Of the 45 candidate indicators presented in the Delphi process, 33 were retained in the final list. The final indicators were grouped in the domains of history taking (13), examination (8), recall (5), referral (6), and patient education (1). All 13 iCareTrack indicators were retained either in the original format or with minor modifications. New history taking indicators included documenting the type of diabetes, serum lipid level, pregnancy status, systemic medications, renal disease, Indigenous status, non-English speaking background, and details of patient’s general practitioner. Examination of pupil, intraocular pressure, optical coherence tomography, and diabetic retinopathy grading were added. Recall period for high-risk group without retinopathy, communication with general practitioner, referral of high-risk proliferative retinopathy, and patient education on regular follow up were also added.

Conclusions : The study described a systematic process of updating clinical indicators. These updated indicators will be the basis for a self-audit tool and allow assessment of diabetic eyecare appropriateness in Australia.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

 

Clinical indicators for diabetic eyecare assessment

Clinical indicators for diabetic eyecare assessment

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