Findings from Optometrists' Practices in Advising about Lifestyle Study

Abstract

SIGNIFICANCE Lifestyle influences eye health and other chronic diseases. All health care providers, not just primary care physicians, should have the necessary information and training to advise and refer patients on lifestyle to take advantage of opportunities to provide such advice. PURPOSE The extent to which optometrists offer lifestyle advice to their patients is largely unknown. The Optometrists' Practices in Advising about Lifestyle (OPAL) study aimed to examine lifestyle advice that optometrists offer, to whom such advice is offered, and reasons for not offering this advice. METHODS We developed and administered a mail-in survey to 140 optometrists in Western New York. RESULTS Five surveys were returned because of death, retirement, and relocation. Of the 135 remaining eligible participants, 46 of the optometrists contacted responded to our survey; however, only 42 (31%) provided signed consent forms. Of these, more than 93% report offering advice on smoking, dietary supplements, and diet, and >59% reported offering on physical activity and alcohol use. Eighty-three percent offer advice to only those with unhealthy behaviors or certain conditions. Most advice consisted of mentioning the lifestyle factor's influence on eye or overall health. Reasons for not offering advice included lack of knowledge or training or the belief that advice would not change behaviors. CONCLUSIONS Optometrists reported offering advice primarily to those with unhealthy lifestyle behaviors or pre-existing health conditions. Future studies should address low response rates, include nonphysician health care providers in addition to optometrists, and also examine patients' perceptions and understanding of the advice offered to better understand whether this advice is received as the provider envisioned.

What Advice Is Currently Given to Patients with Age-Related Macular Degeneration (AMD) by Eyecare Practitioners, and How Effective Is It at Bringing about a Change in Lifestyle? A Systematic Review

“…In contrast to the previous studies described above, this study found that 74% provided advice about smoking, 81% about the importance of a healthy diet and 79% regarding dietary supplements. The number of optometrists discussing smoking with patients with AMD was substantially higher in this study compared to others, but the percentage of practitioners offering dietary supplement advice was lower than previously reported [ 57 ]. However, the sample in this study was smaller than the other studies despite participants being contacted 3 times to encourage a response.…”

“…In another study evaluating only optometrists, Sahli et al (2020) administered postal surveys to 42 optometrists to examine the lifestyle advice that optometrists offer, to whom such advice is offered and reasons for not offering advice [ 57 ]. In contrast to the previous studies described above, this study found that 74% provided advice about smoking, 81% about the importance of a healthy diet and 79% regarding dietary supplements.…”

“…Downie and Keller [ 49 ] and Sahli et al [ 57 ] only surveyed optometrists so the experience of lifestyle advice provision by ophthalmologists was not reported. This is significant as Martin (2017), looking at lifestyle advice given by optometrists ( n = 323) and ophthalmologists ( n = 48) in Sweden, reported that ophthalmologists were more likely to provide smoking cessation advice than optometrists [ 36 ].…”

“…This was suggested to be at least partially attributable to concerns about a negative patient response to questions about smoking [ 55 , 72 ]. Between 62–81% of ECPs reported providing advice regarding dietary change (although the upper limit of the larger studies, i.e., > n = 100 was 68%), while advice regarding nutritional supplements was given by between 67% and 93% (with the upper limit of larger studies, i.e., > n = 100 being 93%) of ECPs surveyed [ 36 , 43 , 49 , 55 , 57 ]. In other words, advice on nutritional supplements was reported as being provided more frequently than advice about diet.…”

“…An important point to consider is that the studies that were reported recently (2020 and later) [ 50 , 52 , 57 , 62 , 78 ] show that there are improved rates of advice provision amongst practitioners compared to earlier studies [ 35 , 36 , 43 , 45 , 49 , 54 , 55 ]. However, this review highlights that there is still a need for further education for practitioners, specifically about the importance of smoking cessation advice.…”