Screening and diagnosing diabetes in optometrists’ practices: an evaluation of perceptions, attitudes and beliefs

Abstract

In the UK, optometrists examine 17 million people yearly, many of whom will not have consulted a doctor and may have undiagnosed diabetes. Selective testing in optometry practices presents a new detection strategy. The purpose of this research was to ascertain optometrists' perceptions, attitudes and beliefs towards diabetes and screening, prior to evaluating a pilot service. Focus groups and interviews were conducted with 21 optometrists in Northern England. Analysis was based on grounded theory. Four themes emerged: varying awareness of diabetes and its early diagnosis, a reluctance in accepting a screening role, organisational barriers in implementing such a service, and controversies around the changing roles of optometrists. Although optometrists' awareness of diabetes was varied, all had seen patients they suspected of having diabetes and felt that the public under‐estimated risks of diabetes. Some felt that diagnosis of asymptomatic diabetes was unnecessary, although most felt that early diagnosis would be beneficial. Optometrists believed that the public and doctors had mixed attitudes to their possible involvement in screening. Specific barriers included additional cost, time, remuneration and litigation fears. However, optometrists felt that their professional role has evolved and that a greater, extended clinical involvement would be positive. In conclusion, optometrists are willing to carry out capillary blood glucose tests, provided that the scheme is simple, is supported by other health care professionals and is properly funded. There is a clear advantage in identifying undiagnosed diabetes in people attending optometry practices who are not accessing other health care providers.