Needs assessment of dry eye disease education for Canadian primary care physicians.

Authors: Matthew Fung, Arpit Dang, Manev Nayeni, Rookaya Mather.

Disclosure Block: M. Fung: None. A. Dang: None. M. Nayeni: None. R. Mather: None.

Abstract Title: A Needs Assessment of Dry Eye Disease Education for Canadian Primary Care Physicians

Abstract Body:

Purpose: Dry eye disease (DED) is a common ocular condition affecting over 20-30% of adults over the age of 50 years. DED symptoms negatively impact daily activities and quality of life. Although, 25% of patients visiting an ophthalmologist endorse symptoms of DED, most patients seek care from first line health care providers such as family physicians (FP), nurse practitioners, and pharmacists. Unfortunately, DED is commonly unrecognized or misdiagnosed in these settings. FPs play an important role in the management of dry eye disease by identifying DED, initiating management strategies and referring to eye-care specialists as required. However, a study conducted in the Netherlands determined that there were significant differences in care of DED patients between FPs and optometrists. In the United Kingdom, dry eye was one of the most misdiagnosed ophthalmologic conditions between eye care specialists and FPs. Currently, there is no data about how FPs manage DED in Canada. This study aims to identify and understand current practice patterns of family physicians with regards to DED across Canada. The results will help identify potential opportunities to optimize management of DED in primary care. Additionally, these results may also inform the needs of future continuing professional development programs.

Study Design: A cross section study was designed by the Dry Eye Disease research at the Ivey Eye Institute, London, Ontario and Western University. A formulated anonymous 17-question Qualtrics electronic questionnaire was administered to FPs to gather information pertaining to: practitioner demographics, perceptions towards DED, comfort level and practice patterns of FPs with regards to managing dry eye symptoms. The comfort level of diagnosing and managing dry eye symptoms was ascertained through multiple Likert scales and multiple-choice options.

Methods: FP responses were assessed globally to ascertain attitudes towards DED management in general. These responses were then stratified based on demographic information (Years in practice, type of practice, Year of graduation and population of practice location) to look for correlations in responses.

Results: FPs reported competency in recognizing and treating common ocular pathologies such as viral, allergic conjunctivitis and chalazions with responses above 90%. Conversely, 34.2% and 33.9% of respondents reported feeling comfortable diagnosing and treating DED respectively. Significant differences in practitioner approach to DED were observed after adjusting for years in practice and year of graduation. Additionally, 67.1% of respondents reported an interest in learning more about DED management. 51.3% of respondents stated a lack of any formalized training regarding DED management.

Conclusions: FPs seem to develop increased competence in managing DED over time despite not having any formalized education on DED. Our study demonstrates a need to develop formalized teaching on DED management during FP residency as well as continuing medical education opportunities that are available to FPs early in their careers and beyond.