School of Optometry and Vision Science, UNSW, Sydney, Australia.
Clin Exp Optom. 2023 Nov;106(8):825-835. doi: 10.1080/08164622.2023.2178286. Epub 2023 Feb 22.
Optometrists play an integral role in primary eyecare services, including prevention, diagnosis, and management of acute and chronic eye conditions. Therefore, it remains essential that the care they provide be timely and appropriate to ensure the best patient outcomes and optimal utilisation of resources. However, optometrists continuously face many challenges that can affect their ability to provide appropriate care (i.e., the care in line with evidence-based clinical practice guidelines). To address any resulting evidence-to-practice gaps, programs are needed that support and enable optometrists to adopt and utilise the best evidence in clinical practice. Implementation science is a field of research that can be applied to improving the adoption and maintenance of evidence-based practices in routine care, through systematic development and application of strategies or interventions to address barriers to evidence-based practice. This paper demonstrates an approach using implementation science to enhance optometric eyecare delivery. A brief overview of the methods used to identify existing gaps in appropriate eyecare delivery is presented. An outline of the process used to understand the behavioural barriers responsible for such gaps follows, involving theoretical models and frameworks. The resulting development of an online program for optometrists to enhance their capability, motivation, and opportunity to provide evidence-based eyecare is described, using the Behaviour Change Model and co-design methods. The importance of and methods used in evaluating such programs are also discussed. Finally, reflections on the experience and key learnings from the project are shared. While the paper focuses on experiences in improving glaucoma and diabetic eyecare in the Australian optometry context, this approach can be adapted to other conditions and contexts.
验光师在初级眼科保健服务中发挥着不可或缺的作用，包括预防、诊断和管理急性和慢性眼病。因此，确保他们提供的护理及时且适当，以确保最佳的患者结果和最佳资源利用仍然至关重要。然而，验光师不断面临许多挑战，这些挑战可能会影响他们提供适当护理的能力（即符合循证临床实践指南的护理）。为了解决由此产生的证据与实践之间的差距，需要有计划来支持和使验光师能够在临床实践中采用和利用最佳证据。实施科学是一个可以应用于改善常规护理中循证实践的采用和维持的研究领域，通过系统地制定和应用策略或干预措施来解决循证实践的障碍。本文展示了一种使用实施科学来增强验光眼科保健服务的方法。简要介绍了用于确定适当眼科保健服务提供方面现有差距的方法。接下来概述了用于了解导致这些差距的行为障碍的过程，涉及理论模型和框架。然后，描述了一个用于增强验光师提供循证眼科保健能力、动机和机会的在线计划的开发过程，该计划使用行为改变模型和共同设计方法。还讨论了评估此类计划的重要性和方法。最后，分享了对该项目的经验和主要学习的反思。虽然本文重点介绍了在澳大利亚验光学背景下改善青光眼和糖尿病眼科保健的经验，但这种方法可以适应其他情况和环境。
