Transforming and Supporting Patient Care - Health Professions ...

315Chapter 13 – Profession of Optometryemployed. Optometrists indicate that they have good working relationshipswith physicians on referrals, and that, when prescribing authorities foroptometrists are fully in force, serious conditions would continue to bereferred to physicians. This will provide highly trained specialists withmore time to treat patients with complex conditions. 13The referral process is an important factor in the management of chronicdiseases. For example, optometrists are often the first health careprofessionals to diagnose diabetes, through assessments of variations invision and fluctuating refraction results. If identified through diabeticretinopathy where an optometrist is seeing the patient for the first time, thepatient is likely to have had the disease for some time. In all cases, thepatient is referred directly to a physician for care.What HPRAC FoundReadiness for ChangeFor several years, optometrists have been authorized to administer DPAsfor diagnostic purposes. The drugs designated under the DPRA includetopical anaesthetics, midriatics and cycloplegics. 14In its 2006 report on Therapeutic Pharmaceutical Agents (TPAs), HPRACrecommended that optometrists have the authority to prescribe drugs, withthe exception of anti-glaucoma drugs, and that glaucoma patients should beco-managed with ophthalmologists. 15 HPRAC also indicated thatoptometrists who graduated prior to 1995 would require additionalcompetencies to prescribe therapeutic drugs. Since the New Directionsreport, the COO has developed extensive bridging and continuouseducation programs, along with new quality assurance programs, to ensureits members have the necessary competencies for prescribing.The categories or classes of drugs that optometrists are requesting areidentical to those submitted for consideration by HPRAC during thepreparation of New Directions, although it was not specified whether thedrug classes or categories were to be included in both or either topical ororal delivery methods. HPRAC is satisfied that optometrists have theeducation and competencies to prescribe those drugs included in theproposed designated drug regulation now in the regulation approvalprocess.There continues to be broad support for this change among optometrists.In the New Directions report, HPRAC acknowledged that in 2004approximately 75 percent of optometrists were qualified to prescribe drugs.Since then, there have been significant continuing education requirementsthat optometrists have met to prepare themselves for this new authority.13Meetings with HPRAC and stakeholders. December 2008.14OPTOMETRY, R.R.O. 1990, Reg. 550. http://canlii.org/on/laws/regu/1990r.550/20080821/whole.html.15HPRAC. New Directions. 2006: 125.HPRAC Critical Links January 2009