title: Agreement in dry eye management between optometrists and general practitioners in primary health care in the Netherlands.
abstract: OBJECTIVE
  To investigate the agreement in dry eye care management between general practitioners (GPs) and optometrists in the Netherlands.
  
  
  METHODS
  A web-based survey was used to investigate the agreement in symptoms associated with dry eye, causes of developing dry eye, and investigative techniques used in practice, between GPs and optometrists. Additional questions surveyed knowledge of the latest research, and co-management of dry eye disease in primary healthcare. The anonymised questionnaire contained 16 forced-choice questions with Likert scales, and was sent to 1471 general medical practitioners and 870 registered optometrists. The response data was stored on an online database, and was converted directly to text format for analysis using SPSS 21 statistical analysis software.
  
  
  RESULTS
  138 optometrists and 93 GPs responded to the survey (Cronbach α=0.885, optometrists, and 0.833, GPs). Almost no agreement was found for all the questions: a statistically significant difference (Chi-square p<0.0001) was found between the optometrists and GPs in the use of investigative techniques, associating symptoms, causes of dry eye (p>0.0001), and dry eye symptoms, except for 'burning sensation of the eye' and 'irritation of the eye' as agreed symptoms, and agreement that dry eye is an age-related disease.
  
  
  CONCLUSIONS
  As the optometrist and the GP are the gatekeepers for secondary healthcare, the fundamental differences in the methods of investigation and interpretation of dry eye-related symptoms, the possible cause of developing dry eye disease, and the therapy given by GPs and optometrists in the Netherlands, may have a significant impact on consistency of patient care.
authors.affiliation: Hogeschool Utrecht, Utrecht, The Netherlands; Cardiff University, School of Optometry and Vision Sciences, Cardiff, UK. Electronic address: Mirjam.vantilborg@hu.nl.
authors.forename: M M A
authors.initials: MM
authors.lastname: van Tilborg
authors.affiliation: University of Waterloo, School of Optometry and Vision Science, Waterloo, ON, Canada.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Murphy
authors.affiliation: Cardiff University, School of Optometry and Vision Sciences, Cardiff, UK.
authors.forename: K S E
authors.initials: KS
authors.lastname: Evans
mesh_terms: D000328:Adult; D001294:Attitude to Health; D002983:Clinical Competence / Q000706:statistics & numerical data*; D015352:Dry Eye Syndromes / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D058005:General Practitioners / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D009907:Optometry / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data; D016526:Workload / Q000706:statistics & numerical data
keywords: Co-management; Dry eye disease; GPs’; Investigation techniques; Optometric care; Primary healthcare