Scientia PhD Candidate
Research Title: iCaretrack 2: Theory-based Approach to Improving the Appropriateness of Glaucoma Eyecare Delivery within Australia
Quality and safety of healthcare delivery is an area of increasing interest for health policy makers and governments as poorly delivered healthcare services lead to sub-optimal outcomes for patients and an increase the burden of disease for society. A consistent finding in health services research is the failure to effectively translate research into practice, with a gulf existing between best-evidence and actual practice.
Glaucoma is a progressive optic neuropathy that can result in vision impairment and blindness. In Australia glaucoma is a leading cause of irreversible blindness with a prevalence of 3.4% for non-indigenous Australians of which approximately 50% are undiagnosed. The Australian National Eye Health Survey has recommended improved case detection for glaucoma. The iCaretrack study found that glaucoma eyecare was delivered appropriately at 63% (95%CI 61-64%) of patient interactions by Australian optometrists. This evidence-to-practice gap for glaucoma is a concern as it may result in delayed diagnosis and avoidable vision loss.
To improve case detection, prevention and management of glaucoma the evidence-to-practice gap needs to be closed. Implementation science, the study of methods to promote the systematic uptake of research and evidence-based practice (i.e. knowledge translation), evolved to address evidence-to-practice gaps with the view to improving the quality and safety of healthcare services. In this research, theories, models and frameworks from Implementation Science will be used to explore and critically analyse the glaucoma care evidence-to-practice gap, then to identify develop, and test improvement strategies.
The primary research aim of this research is to identify, develop and assess intervention strategies through systematic methods that will close the evidence-to-practice gap, with the overarching goal of improving the appropriateness of glaucoma eyecare delivery by Australian optometrists. The specific study objectives are:
To investigate and understand the determinants (i.e. barriers and facilitators) of glaucoma care by Australian optometrists.
To design a theory-based tailored implementation strategy to improve the delivery of evidence-based glaucoma care by Australian optometrists.
To test the efficacy of a theory-based tailored implementation strategy to improve evidence-based glaucoma care by Australian optometrists.
Melinda graduated from QUT in 1993 with a Bachelor of Applied Science (Optometry). Melinda’s career has been varied, practicing in public hospitals, private practice, corporate practice and university settings, in roles ranging from clinical, managerial and educator. During this time Melinda developed a special interest in ocular diseases, ocular therapeutics, evidence-based practice and public health optometry. Melinda has also gained the following qualifications: MBA, Master of Optometry, and Graduate Certificate in Ocular Therapeutics. Melinda has both participated in and lead teams providing eyecare to Indigenous communities in Australia and an international mission to Panama.
Bachelor Applied Science (Optometry), QUT, 1993
Master of Business Administration, Southern Cross University, 2011
Master of Optometry UNSW, 2016
Graduate Certificate Ocular Therapeutics, UNSW, 2017
- Gyawali R, Toomey M, Stapleton F, Jalbert I. Clinical record keeping in glaucoma. MiVision March 2019 Available: https://www.mieducation.com/clinical-record-keeping-in-glaucoma/
The Postgraduate Ocular Therapeutics Prize UNSW 2018
BMJ International Symposium on Quality & Safety in Healthcare, Glasgow, 2019
ARVO, Vancouver, Canada, 2019
AFFILIATIONS AND MEMBERSHIPS
Optometry Queensland and Northern Territory President
American Academy of Optometry Student Member