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Optometry independent prescribing during COVID lockdown in Wales
Paul Cottrell1,2, Rachel North1, Nik Sheen3
1School of Optometry and Vision Sciences, Cardiff University, Cardiff, UK.
Summary
Commissioned Independent Prescribing Optometry Services (IPOS) in Wales improved urgent eye care during COVID-19. IPOS enabled optometrists to manage more conditions, reducing ophthalmology referrals and increasing patient follow-ups.
Area of Science:
- Ophthalmology
- Optometry
- Public Health
Background:
- During COVID-19, Welsh optometry shifted to a hub model.
- Three independent prescribing models were compared: commissioned IPOS, non-commissioned prescribers, and no prescribers.
Purpose of the Study:
- To analyze patient presentations to urgent eye services.
- To compare drug prescriptions and onward referrals across different independent prescribing models.
Main Methods:
- Online surveys from 81 optometry practices covering 22,434 patient episodes.
- Analysis of urgent care appointments, presenting symptoms, diagnoses, and prescribed medications.
- Comparison of outcomes between areas with IPOS, non-commissioned prescribers, and no prescribers.
Main Results:
- Urgent care comprised 49% of first appointments; 80% were self-referred.
- Eye pain/discomfort and anterior segment pathology were most common.
- IPOS areas saw more medication prescriptions, more optometric follow-ups, and fewer urgent ophthalmology referrals.
Conclusions:
- Urgent care is vital for anterior eye conditions.
- IPOS facilitates optometrist-led condition resolution, reducing referrals.
- Commissioners should support IPOS to alleviate ophthalmology burden and ensure follow-up care.
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