Clinical Trial: Independent Prescribing Optometrists in Acute Ophthalmic Services

Study Status: Recruiting
Recruit Status: Recruiting
Study Type: Observational

Official Title: Independent Prescribing Optometrists in Acute Ophthalmic Services

Brief Summary:

The UK government's Crown report titled 'Review of prescribing, supply & administration of medicines' enabled optometrists to train for the qualification of independent prescribing (IP). The UK introduced IP for optometrists in 2009. The proposed research focuses on the role of IP optometrist in the acute ophthalmic services of Manchester Royal Eye Hospital (MREH). The study will compare IP optometrists to consultant ophthalmologists in the ability to diagnose, manage and prescribe medication for patients accessing these services.

To achieve this comparison consenting participants will first have a clinical assessment with the IP Optometrist, where findings including diagnosis and management plan will be recorded onto a research proforma. The consultant ophthalmologist will be masked to the IP Optometrist's research proforma to prevent bias. The consultant ophthalmologist will then perform a clinical assessment on a second proforma and inform the participant of their diagnosis and management plan. Percentage agreement, kappa (κ) and weighted κ will be calculated for a range of parameters between the two proformas. Disagreement in diagnosis or management will be arbitrated by a separate ophthalmologist participating in the study with a specialty relevant to the participant's condition.

The main objective of the research is to expand the limited base of evidence of of IP optometrists' ability to diagnose, manage and prescribe medication and to determine whether they work at least as safely and effectively as consultant ophthalmologists in acute ophthalmic services. It is the first study in this area since the advent of IP for optometrists, with only one previous study published before IP was introduced. The research will enable the type and frequency of conditions presenting in these services to be measured. Fu

Detailed Summary:

What are the purpose and objectives of the research?

The primary aim of this prospective, masked, controlled comparative study is to measure the agreement in diagnosis between IP optometrists and the reference standard of consultant ophthalmologists.

A secondary aim is to measure agreement in management of the diagnosis, including the decision whether or not to prescribe medication. The choice of not prescribing medication is an important prescribing decision and will be counted as such. This measure is the novel aspect of the research as it provides evidence of IP optometrists' ability to safely prescribe.

What is the scientific justification for the research?

The NHS's emergency services are experiencing increasing demand (Ismail et al 2013), which is also true of MREH's Acute Referral Centre where IP optometrists work as part of a multidisciplinary team. There is a scientific need to provide an evidence base to validate and support the role of optometrists working in acute ophthalmic services, as well as provide evidence of IP optometrist's ability to safely prescribe medication. This evidence base may in turn lend support to nationally extending the role of IP Optometrists' and their skills to the benefit of the Health Service. Establishing an audit meets the clinic need to monitor performance of IP optometrists working in this extended role. Guidelines for IP optometrists working within MREH Acute Ophthalmic Services offer a way to optimise the running of the clinic as patient can be triaged to clinicians and ophthalmologists feed to see complex cases.

A novel aspect of this study is that it will compare optometrists' management decisions involving the prescribing of ocu
Sponsor: Aston University

Current Primary Outcome: Prescribing decision [ Time Frame: Through study completion - up to 18 months ]

Original Primary Outcome: Same as current

Current Secondary Outcome:

Original Secondary Outcome:

Information By: Aston University

Dates:
Date Received: October 14, 2015
Date Started: November 2015
Date Completion: December 2018
Last Updated: September 14, 2016
Last Verified: September 2016