title: The self-reported clinical practice behaviors of Australian optometrists as related to smoking, diet and nutritional supplementation.
abstract: OBJECTIVE
  The 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.
  
  
  METHODS
  A 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.
  
  
  RESULTS
  A 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.
  
  
  CONCLUSIONS
  These 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.
authors.affiliation: Department of Optometry and Vision Sciences, University of Melbourne, Parkville, Victoria, Australia 3010.
authors.forename: Laura Elizabeth
authors.initials: LE
authors.lastname: Downie
authors.affiliation: Department of Optometry and Vision Sciences, University of Melbourne, Parkville, Victoria, Australia 3010; Macular Research Unit, Centre for Eye Research Australia, East Melbourne, Victoria, Australia 3002.
authors.forename: Peter Richard
authors.initials: PR
authors.lastname: Keller
mesh_terms: D000328:Adult; D001315:Australia; D002648:Child; D004032:Diet; D019587:Dietary Supplements; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D007223:Infant; D008875:Middle Aged; D009907:Optometry; D012907:Smoking; D000078329:Workforce; D055815:Young Adult