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Review
. 2024 Dec 20;11(12):1548.
doi: 10.3390/children11121548.

Pharmaceutical Prescribing Privileges for Optometrists to Combat Childhood Myopia in Singapore: Public Health Policy Review and Analysis

Tiong Peng Yap  1   2 , Masuma Pervin Mishu  2
Affiliations
Review

Pharmaceutical Prescribing Privileges for Optometrists to Combat Childhood Myopia in Singapore: Public Health Policy Review and Analysis

Tiong Peng Yap et al. Children (Basel). .

Abstract

Singapore's national myopia prevention efforts have largely focused on school vision screening and public education on outdoor activities in the past two decades. Given the emergence of evidence-based myopia interventions, this policy review and analysis investigates the potential benefits and drawbacks of optometrist prescribing privileges as it has been proposed to reduce the barriers to access effective interventions, such as combined therapy (e.g., orthokeratology treatment and low-dose atropine therapy). In this policy analysis, two policy options were identified to be feasible based on evidence from a systematic literature search and they were analysed along with status quo using the Centers for Disease Control and Prevention (CDC) Policy Analysis Framework. This includes independent prescribing and supplementary prescribing, where the former entails autonomous clinical decision making, and the latter entails co-management with ophthalmological supervision. The policy review and analysis found independent prescribing the most favourable and concluded that this should be implemented in view of its benefits for the community. Public health impact is expected to be substantial due to increased patient access, reduced treatment costs, early interventions, improved treatment compliance, and reduced wait times and inconvenience. It is feasible because treatment processes can be streamlined, and it can be implemented based on existing collaborative prescribing frameworks. Economical and budgetary impact is also substantial given the direct savings generated, which can consequently help to reduce the disease burden.

Keywords: evidence-based myopia interventions; myopia; public health policy review.

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Conflict of interest statement

The first author, Yap Tiong Peng, PhD, is an optometrist and an independent researcher in Singapore. He is an elected council member and life member of the Singapore Optometric Association, and a member of The College of Optometrists, London, UK. The co-author, Masuma Pervin Mishu, PhD, is a lecturer and researcher in Public Health at the Institute of Epidemiology and Healthcare, Faculty of Population Health Sciences, University College London, UK.

Figures

Figure 1
Figure 1
Schematic representation of the National Myopia Prevention Programme (NMPP), referral pathways of the school vision screening programme, and the current role of ophthalmologists, optometrists, and opticians in managing children with evidence-based myopia interventions.
Figure 2
Figure 2
A vicious circle of myopia progression due to under- or un-corrected myopia, which may disproportionately affect low-income families and widen health inequities.
Figure 3
Figure 3
Annual treatment cost savings for each patient in Singapore dollars (S$) when comparing between independent and supplementary prescribing by optometrists.
See this image and copyright information in PMC

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