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

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.