Evaluation of a clinical decision making aid for nutrition advice in age-related macular degeneration

Stevens, Rebekah, Bartlett, Hannah and Cooke, Richard (2017). Evaluation of a clinical decision making aid for nutrition advice in age-related macular degeneration. British Journal of Visual Impairment, 35 (3), pp. 185-196.

Abstract

Age-related macular disease (AMD) is a multifactorial degenerative condition affecting the central area of the retina. Patients with AMD report that eye care practitioners are not giving consistent advice regarding nutrition and reported confusion as to what advice, if any, to follow. The aim of this study was to design and conduct a preliminary evaluation of a flowchart to support eye care practitioners in providing accurate, evidence-based nutritional advice to their patients. A flowchart was designed to take practitioners through a decision-making process that would determine whether a patient matched the Age-Related Eye Disease Study (AREDS) 2 eligibility criteria for supplementation. The flowchart was evaluated using a qualified and student optometrist cohort, with both cohorts completing confidence scales and students completing clinical scenarios. Qualified participants showed a significant increase in confidence scores from the initial survey (M = 69.7%, standard deviation [SD] = 16.2%) to the second survey after use of the flowchart for 2 weeks (M = 82.1%, SD = 11.6%; t(45) = 7.33, p < .001; rs = .61, p < .001). The student participants also increased confidence scored after receiving the flowchart (M of first survey = 41.7, SD = 14.6; M of second survey = 69.1, SD = 1.7; t(25) = 7.92, d = .81, p < .001) and increased the number of correct answers on five clinical scenarios. Overall, the flowchart has proved to be useful in boosting the self-efficacy of both qualified practitioners and student practitioners, as well as improving clinical decisions made by student practitioners.

Publication DOI: https://doi.org/10.1177/0264619616683989
Divisions: Life & Health Sciences > Optometry
Life & Health Sciences > Ophthalmic Research Group
Life & Health Sciences
Life & Health Sciences > Psychology
Life & Health Sciences > Applied Health Research Group
Additional Information: © The Author(s) 2017. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
Uncontrolled Keywords: age-related macular degeneration,clinical decision-making aid,flowchart,nutrition
Published Date: 2017-09-01
Authors: Stevens, Rebekah
Bartlett, Hannah ( 0000-0002-7531-6902)
Cooke, Richard ( 0000-0003-0476-6284)

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