Confidence of Saudi Optometrists with Ocular Therapeutic Pharmaceutical Agents Use in Optometry Practice

Research Article

Austin J Pharmacol Ther. 2024; 12(1): 1184.

Confidence of Saudi Optometrists with Ocular Therapeutic Pharmaceutical Agents Use in Optometry Practice

Aldarwesh A*

Department of Optometry, King Saud University, Saudi Arabia

*Corresponding author: Aldarwesh A Department of Optometry, King Saud University, Riyadh, Saudi Arabia. Tel: 00966118058153 Email: aaldarweesh@ksu.edu.sa

Received: December 27, 2023 Accepted: January 30, 2024 Published: Febryary 06, 2024

Abstract

This study investigates confidence around Therapeutic Pharmaceutical Agents (TPAs) in optometry practice in Saudi Arabia, determines whether training and education are required, and highlights areas of weakness. Optometrists were invited to participate in a self-administered online survey open for 30 days in November 2023. The survey consisted of seven closed-ended questions covering demographic characteristics and eleven 5-point Likert-scale sentences reflecting confidence regarding TPAs use in practice and their ability to educate patients with ocular conditions regarding drug actions, side effects, and medication adherence. Two hundred and ninety optometrists responded. Most were young (46.6%, ages 25–30), held a Optommetry doctor (OD) degree, and were in practice for 1–5 years (34/1%). The overall confidence scale score is 4.14.1±0.75(SD). Approximately 80% were confident or highly confident in all competencies. No association was found between age, work experience duration, and educational levels with confidence scores. However, female individuals were less confident across all categories. Saudi optometrists have high confidence in using TPAs in practice and patient education. Gender differences were found as female female optometrists perceived themselves as less confident. The optometric workforce in Saudi Arabia must be supported with continuous education in therapeutics to support their role in providing primary eye care.

Keywords: Confidence; TPAs; Ocular; Drugs; Optometrists

Introduction

The optometry profession’s status has changed over the past decades from mere refractionists to primary eye care professionals serving a growing population, providing screening and managing chronic eye conditions. World Council of Optometry describes the optometry profession as follows: “Optometry is a healthcare profession that is autonomous, educated, and regulated (licensed/registered), and optometrists are the primary healthcare practitioners of the eye and visual system who provide comprehensive eye and vision care, which includes refraction and dispensing, detection/diagnosis and management of disease in the eye, and the rehabilitation of conditions of the visual system.” [1] Moreover, the Global Competency-Based Model of Scope of Practice in Optometry, developed by the WCO, is based on four categories of services: optical technology, visual function, ocular diagnostic, and ocular therapeutic services. The latter includes using ocular Therapeutic Pharmaceutical Agents (TPAs) to investigate, diagnose, and manage ocular conditions [1]. Ocular TPAs include topical antibiotics, antihistamines, analgesics, and anti-inflammatories. Nevertheless, in many countries, legislation permits optometrists only to perform refraction and prescribe spectacles [2]. In others, they are allowed to use diagnostic topical ocular drugs, including mydriatics, cycloplegics, local anesthetics, and ophthalmic dyes and stains [3-5]. In contrast, reports from the United Kingdom (UK) [6], Australia [7,8], and Ghana [9] show that health legislation governing the optometry practice in these countries expands the scope of practice, allowing optometrists to prescribe ocular PTAs. In some countries like Australia, legislation was changed, allowing optometrists to use and prescribe topical ophthalmic medications to manage eye conditions [10]. However, this change requires that optometrists possess therapeutic competencies to prescribe medications through training and licensing. This goal can be achieved by including this training during the undergraduate studies or through additional training after graduating [10]. A national survey study by George et al. [3] revealed that approximately 43% of Singapore optometrists indicated their need to continue professional education in ocular pharmacology. Similarly, a survey of Portuguese optometrists regarding the competencies and scope of practice in optometry showed that applied ocular pharmacology received the highest score for the most crucial training needs [4]. This result indicates the need for undergraduate education, curriculum changes, and professional training certificates/activities post-graduation. This training was also recommended by Rodríguez-Zarzuelo et al., [11] who recommended updating the curriculum of the university degree in Optics and Optometry at the University of Valladolid to improve the competencies of the graduates to meet the professional requirements of optometry practice.

In Saudi Arabia, optometry education started at King Saud University in the early 1980s, by establishing a bachelor’s degree in optometry. It provided the country with qualified optometrists who served as healthcare specialists in government and private hospitals. For a decade, the Optometry Doctor program has replaced the old curriculum and provided the graduates with intense clinical training and insight into ocular diseases and management. This study aims to determine the prevalence of prescriptions/recommendations of ocular TPAs by optometrists in different health sectors in Saudi Arabia. Moreover, it assesses optometrists’ self-confidence regarding TPA prescriptions and patient education, This is the first study in Saudi Arabia to address the optometrists’ opinions regarding confidence in their ability to prescribe ocular drugs and pharmaceutical preparation.

Materials and Methods

Study Population

This cross-sectional, internet-based questionnaire design study was conducted between November and December 2023. Licensed optometrists by the Saudi Commission for Health Specialties (SCFHS) were invited to complete an online survey. Participants were recruited with assistance from the SCFHS (https://www.scfhs.org.sa/en), who sent invitations to registered optometrists in their database. Additionally, the author forwarded invitations to optometrists through social media such as Twitter and official WhatsApp groups. Participants who worked for one year or less with at least a bachelor’s degree in optometry were included in the study.

Ethical Considerations

This study was approved by the Subcommittee of Human and Social Research Ethics at King Saud University (Approval number KSU-HE-23-910). The author did not obtain written informed consent; instead, an electronic version containing elements of consent in Arabic was provided at the start of the survey. The consent included the study’s title in Arabic and English and its purpose, the estimated time required to answer the survey, and information about anonymity, data security, and voluntary participation. Additionally, the author’s contact information was provided.

Sample Size and Research Tool

The sample size was estimated using Cochran’s equation for small populations of a known size. The estimated sample size of registered optometrists in Saudi Arabia was 1886 in 2021 [12]; the number was rounded to 2000. Based on the population size of 2000 and a margin of error of +/- 5% at Confidence Interval (CI) levels of 95% with a z score of 1.96. The final sample size was 323, and 290 participants completed the survey. The research tool consists of two sections. First, demographic data was collected, including age, sex, educational degree, years of experience, confirmation of current employment status, and the type of pharmaceutical therapeutic agents the optometrist recommends or prescribes. The second section contains 11 sentences that participants need to rate using a 5-Likert confidence scale (1=not at all confident, 2=not confident, 3=somewhat confident, 4=confident, and 5=completely confident), with the scores ranging between 11 and 55, and higher scores indicate higher levels of self-efficacy.

Statistical Analysis

Data was analyzed using GraphPad Prism (Version 10.1.1 (270) for Mac OS, GraphPad Software, Boston, Massachusetts USA, www.graphpad.com). Descriptive statistics were calculated in which continuous variables like confidence scores were presented as mean ± Standard Deviation (SD). In contrast, categorical variables such as age groups and duration of experience were presented as absolute and relative frequencies. The comparison of confidence scores for each question between male and female participants was achieved using the Mann- Whitney U-test. The association between the confidence level and the demographic variables was found using the Chi-square or Fisher test as appropriate. The result was considered significant at P<0.05. The internal consistency of the confidence scale was determined using Cronbach’s alpha and the inter-item correlation.

Results

Internal Consistency

The internal consistency of the confidence scale was determined using Cronbach’s alpha and the inter-item correlation. Cronbach’s alpha for the scale is 0.92, indicating excellent consistency. The mean inter-item correlation for the 11 items in the scale is 0.51, indicating a good correlation of all statements in the confidence scale. Table 1 shows the details of the item analysis.