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. 2021 Jan 1;98(1):24-31.
doi: 10.1097/OPX.0000000000001629.

Indicators for Assessing the Quality of Refractive Error Care

Ling Lee, Anthea M Burnett, Fabrizio D'Esposito  1 , Tim Fricke  2 , Long Tien Nguyen  3 , Duong Anh Vuong  4 , Hien Thi Thu Nguyen  5 , Mitasha Yu  2 , Ngoc Viet My Nguyen  3 , Ly Phuong Huynh  6 , Suit May Ho
Affiliations

Indicators for Assessing the Quality of Refractive Error Care

Ling Lee et al. Optom Vis Sci. .

Abstract

Significance: Quality refractive error care is essential for reducing vision impairment. Quality indicators and standardized approaches for assessing the quality of refractive error care need to be established.

Purpose: This study aimed to develop a set of indicators for assessing the quality of refractive error care and test their applicability in a real-world setting using unannounced standardized patients (USPs).

Methods: Patient outcomes and three quality of refractive error care (Q.REC) indicators (1, optimally prescribed spectacles; 2, adequately prescribed spectacles; 3, vector dioptric distance) were developed using existing literature, refraction training standards, and consulting educators. Twenty-one USPs with various refractive errors were trained to visit optical stores across Vietnam to have a refraction, observe techniques, and order spectacles. Spectacles were assessed against each Q.REC indicator and tested for associations with vision and comfort.

Results: Overall, 44.1% (184/417) of spectacles provided good vision and comfort. Of the spectacles that met Q.REC indicators 1 and 2, 62.5 and 54.9%, respectively, provided both good vision and comfort. Optimally prescribed spectacles (indicator 1) were significantly more likely to provide good vision and comfort independently compared with spectacles that did not meet any indicator (good vision: 94.6 vs. 85.0%, P = .01; comfortable: 66.1 vs. 36.3%, P < .01). Adequately prescribed spectacles (indicator 2) were more likely to provide good comfort compared with spectacles not meeting any indicator (57.7 vs. 36.3%, P < .01); however, vision outcomes were not significantly different (85.9 vs. 85.0%, P = .90). Good vision was associated with a lower mean vector dioptric distance (P < .01) but not with comfort (P = .52).

Conclusions: The optimally prescribed spectacles indicator is a promising approach for assessing the quality of refractive error care without additional assessments of vision and comfort. Using USPs is a practical approach and could be used as a standardized method for evaluating the quality of refractive error care.

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Conflict of interest statement

Conflict of Interest Disclosure: The sponsor participated in conceptualization, study design, and data interpretation. The authors were responsible for the preparation of this manuscript and the decision to submit this article for publication. Each of the authors had full access to the study data and takes full responsibility for their presentation in this article.

Figures

FIGURE 1
FIGURE 1
Associations between prescribed spectacles and vision and comfort outcome. **Significant at P < .05. ***Significant at P < .001.
None
See this image and copyright information in PMC

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