Drug-prescribing patterns among optometrists and nonophthalmologist physicians at a tertiary care centre in Kingston, Ontario.
OBJECTIVE
To report on patterns of optometry prescribing and adherence to prescribing regulations at a tertiary care ophthalmology centre.


METHODS
Prospective cohort study.


METHODS
All new referrals from optometrists and other health care professionals to the emergency eye care service (n = 1965) between July 2011 and June 2012, as well as optometry referrals to 2 subspecialty services (glaucoma [n = 71] and cornea [n = 212]).


METHODS
In our primary analysis, the frequency of prescribing and classes of medications prescribed were reported and compared amongst various referral sources to the emergency eye care service. As a secondary analysis, we reported frequency of prescribing in optometry referrals to 2 subspecialty clinics. Adherence to prescribing guidelines was reported for all optometry referrals.


RESULTS
Of 296 referrals from optometrists to the emergency eye care service, 20 (6.8%) had received a prescription medication; this was significantly less compared to emergency and family physicians (p < 0.001). Topical antibiotics were the most frequently prescribed medication class. The frequency of prescribing by optometrists was 5.2% (11/212) and 4.2% (3/71) for patients referred to the cornea and glaucoma services, respectively. Among those patients referred after being given a prescription for a glaucoma medication by an optometrist, 89% cases (8/9) did not adhere to prescribing regulations.


CONCLUSIONS
After the introduction of prescribing privileges, optometrists prescribe a variety of medications in their practices. Current prescribing guidelines are not always followed in practice, suggesting that continued study and collaboration is necessary to create an optimal model of interdisciplinary care that provides access to the highest quality of care.
Department of Ophthalmology, Queen's University, Kingston, Ont; Department of Ophthalmology, Hotel Dieu and Kingston General Hospitals, Kingston, Ont.
Davin
D
Johnson
Department of Ophthalmology, University of Toronto, Toronto, Ont; Department of Ophthalmology, Kensington Eye Institute, Toronto, Ont.
Sherif R
SR
El-Defrawy
Department of Ophthalmology, Queen's University, Kingston, Ont; Department of Ophthalmology, Hotel Dieu and Kingston General Hospitals, Kingston, Ont; Institute for Clinical Evaluative Sciences, Toronto, Ont.
Simon
S
Hollands
Department of Ophthalmology, Queen's University, Kingston, Ont; Department of Ophthalmology, Hotel Dieu and Kingston General Hospitals, Kingston, Ont.
Jonathan
J
Hurst
Department of Ophthalmology, Queen's University, Kingston, Ont; Department of Ophthalmology, Hotel Dieu and Kingston General Hospitals, Kingston, Ont.
Christine
C
Law
Department of Ophthalmology, Queen's University, Kingston, Ont.
Cody
C
Li
Department of Ophthalmology, Queen's University, Kingston, Ont; Department of Ophthalmology, Hotel Dieu and Kingston General Hospitals, Kingston, Ont.
Stephanie
S
Baxter
Department of Ophthalmology, Queen's University, Kingston, Ont; Department of Ophthalmology, Hotel Dieu and Kingston General Hospitals, Kingston, Ont.
Erica de L P
Ede L
Campbell
Department of Ophthalmology, Queen's University, Kingston, Ont; Department of Ophthalmology, Hotel Dieu and Kingston General Hospitals, Kingston, Ont; Institute for Clinical Evaluative Sciences, Toronto, Ont. Electronic address: rob.campbell@queensu.ca.
Robert J
RJ
Campbell
D015331:Cohort Studies; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004632:Emergency Medical Services; D005260:Female; D019983:Guideline Adherence; D019538:Health Care Surveys; D006302:Health Services Research; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D000072162:Optometrists / Q000706:statistics & numerical data*; D010820:Physicians / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data; D062606:Tertiary Care Centers / Q000706:statistics & numerical data*