The Self-Reported Clinical Practice Behaviors of Australian Optometrists as Related to Smoking, Diet and Nutritional Supplementation

Abstract

ObjectiveThe primary aim of this study was to examine the self-reported, routine clinical practice behaviors of Australian optometrists with respect to advice regarding smoking, diet and nutritional supplementation. The study also sought to assess the potential influence of practitioner age, gender, practice location (major city versus regional), therapeutic-endorsement status and personal nutritional supplementation habits upon management practices in these areas.MethodsA survey was electronically distributed to Australian optometrists (n = 4,242). Respondents anonymously provided information about their personal demographics and lifestyle behaviors (i.e., age, gender, practice location, therapeutic-endorsement status, smoking status, nutritional supplement intake) and routine patient management practices with respect to advice across three domains: smoking, diet and nutritional supplementation. Multivariate logistic regression analyses were performed to assess for potential effects of the listed factors on practitioner behavior.ResultsA total of 283 completed surveys were received (completed survey response rate: 6.7%). Fewer than half of respondents indicated routinely asking their patients about smoking status. Younger practitioners were significantly (p < 0.05) less likely to enquire about patients’ smoking behaviors, but this did not extend to counseling for smoking cessation. Almost two-thirds of respondents indicated routinely counseling patients about diet. About half of practitioners specified routinely asking their patients about nutritional supplement intake; this form of questioning was significantly more likely if the respondent was female (p < 0.05). Practitioners who recommended nutritional supplements most commonly did so for age-related macular degeneration (91.2%) and dry eye disease (63.9%). The primary source of evidence used to guide practitioners’ nutrition-related patient management was reported to be peer-reviewed publications.ConclusionsThese findings demonstrate that there are no clear predictors of practitioner behavior across the three domains. Overall, this study suggests that there is scope for Australian optometrists to improve their routine engagement by questioning patients, as well as providing evidence-based clinical advice, about smoking status, diet and nutritional supplement behaviors, being key modifiable lifestyle risk factors with long-term implications for eye health.

Knowledge, perspectives and clinical practices of Australian optometrists in relation to childhood myopia

“…These findings suggest that optometrists prefer pre‐appraised and synthesised evidence, over independently accessing primary sources and undertaking their own appraisal and interpretation of research studies. These preferences mirror those reported for other areas of optometric practice, including dry eye disease and age‐related macular degeneration …”

What do patients think about the role of optometrists in providing advice about smoking and nutrition?

“…Smoking cessation is a complex issue. Primary eye care clinicians indicate that the care they provide to patients in relation to advice to quit smoking is influenced by multiple factors; it can be limited by consultation time constraints, a perception of sufficient public awareness about the health risks and/or the view that questioning patients about smoking behaviour is relatively awkward and intrusive . Similar perceived barriers were described in a study that surveyed ophthalmologists and optometrists practicing in the United States .…”

“…Recent studies that have surveyed primary eye care clinicians practicing in various regions of the world, highlight similar deficiencies in care provision in this practice area. Our recent research, which evaluated the self‐reported routine practices of Australian optometrists, suggests that less than half of practitioners routinely enquire about their patient's smoking behaviours . Corroborating this finding are the data in the present survey, in which about only about one‐third of patients indicated that their optometrist had asked them about their smoking behaviours.…”

“…Despite the established link between tobacco smoking and adverse ocular health outcomes, recent studies that have surveyed eye care clinicians in different parts of the world report similar deficiencies in care provision in this practice area. Our research, which investigated self‐reported optometric practices in Australia, indicates that only about half of optometrists routinely enquire about their patient's smoking behaviours . In this study, one barrier cited by clinicians who reported not providing smoking cessation counselling was that they felt patients might consider the discussion of this topic too personal or intrusive.…”

“…Given the links between nutrition and ocular disease, optometrists should also assume a role in discussing these associations with their patients and providing advice about the merit, or otherwise, of different foods and/or nutritional supplements for modifying eye health. We previously reported that 60% of Australian optometrists self‐reported routinely counselling patients about their diet . However, as for smoking cessation, little is currently known about whether patients expect, and/or are receptive, to engage in discussions about diet with their optometrist in the context of its implications on eye health.…”