Screening rates for diabetic retinopathy could be improved
MedWire News: Being aware of the benefits of diabetic retinopathy (DR) screening encourages diabetes patients to attend eye clinic appointments, report researchers.
They add that attendance rates are also affected by the proportion of patients being recommended by their healthcare provider to go for DR screening.
"The key to increasing attendance may lie with health professionals raising awareness about the benefits of screening," write Jeanet Blom (Leiden University Medical Center, the Netherlands) and colleagues.
As reported in the journal Diabetes Research and Clinical Practice, the team sent a questionnaire to 2363 Type 1 and 2 diabetes patients registered with 20 general practices in Holland. The questionnaire was designed to measure attendance rates, and potential incentives and barriers influencing attendance.
The researchers report that 1917 (81.0%) of the patients had undergone DR screening in the past 3 years while 499 (19.0%) had not.
People who attended screening more often had a higher education level (defined as education beyond the age of 12) than those who had not attended (91.6 vs 85.4%).
They were also more likely to have had a diabetes duration of more than 10 years (44.7 vs 33.2%) and to be taking insulin (14.5 vs 4.8%) compared with nonattendees.
The study revealed that certain incentives were reported significantly less frequently by individuals who did not attend than by those who did. The nonattendees less frequently reported an eye screening recommendation made by their care provider (34.5 vs 99.4%), awareness of the effects of DR on visual acuity (90.1 vs 96.8%), and a feeling of obligation to attend screening (91.1 vs 98.7%).
The nonattendees also more frequently reported barriers preventing their attendance than did attendees. These included no recommendation being made by the care provider (65.5 vs 0.6%), no awareness of the effects of DR on vision (9.9 vs 3.2%), the belief that screening is not useful after 70 years of age (12.9 vs 1.5%), and not having confidence in doctors (4.2 vs 1.4%).
However, the study revealed a large variation in screening rates between the practices (59-92%) which "indicates that practice organization can probably modify attendance," say the researchers.
Apart from the more personal views on incentives and barriers, effective areas to increase attendance seem to be related to knowledge, awareness , and instruction, say Blom et al.
"Thus general practitioners, internists, and practice nurses should focus on information, recommendation, and follow-up to encourage attendance in DR screening," writes the team.
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By Sally Robertson