Factors that influence the patient uptake of diabetic retinopathy screening

Dervan, Edward; Lillis, D. L.; Flynn, Lorna; Staines, Anthony; O’Shea, Donal

doi:10.1007/s11845-008-0192-5

Cited by 72 publications

(95 citation statements)

References 23 publications

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“…23 A lack of knowledge about the need for screening was also identified as a barrier to attendance in Ireland. 24 As part of routine patient education, there is a need to create greater awareness of the importance of retinopathy screening as well as explicitly highlighting the risk of asymptomatic disease and the risks of blindness. 23 The prevalence of retinopathy internationally varies widely, depending on methodology and the population sampled; however, the results of this study are in line with international estimates.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

Quality-assured screening for diabetic retinopathy delivered in primary care in Ireland: an observational study

Hugh

Buckley²,

Murphy³

et al. 2013

Br J Gen Pract

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BackgroundAt present, there is no national population-based retinopathy screening programme for people in Ireland who have diabetes, such as those operating in the UK for over a decade. AimTo evaluate a community-based initiative that utilised existing resources in general practice and community optometry/ophthalmology services to provide screening for diabetic retinopathy. Design and settingCross-sectional study using electronic ophthalmic patient screening records in community optometry clinics in Cork, Ireland. MethodA purposive sample of 32 practices was recruited from Diabetes in General Practice, a general practice-led initiative in the South of Ireland. Practices invited all adult patients registered with diabetes to participate in free retinopathy screening (n = 3598), provided by 15 community optometry practices and two community ophthalmologists. Data were recorded on an electronic database used by optometrists and the performance was benchmarked against proposed national standards for retinopathy screening. ResultsIn total, 30 practices participated (94%). After 6 months, 49% of patients (n = 1763) had been screened, following one invitation letter and no reminder. Forty-three per cent of those invited consented to their data being used in the study and subsequent analyses are based on that sample (n = 1542). The mean age of the patients screened was 65 years (standard deviation = 13.0 years), 57% were male (n = 884), and 86% had type 2 diabetes (n = 1320). In total, 26% had some level of retinopathy detected (n = 395); 21% had background retinopathy (n = 331), 3% had preproliferative retinopathy (n = 53), and 0.7% had proliferative retinopathy (n = 11). ConclusionThe detection of retinopathy among 26% of those screened highlights the need for a national retinopathy screening programme in Ireland. Significant learning, derived from the implementation of this initiative, will inform the national programme.

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Section: Comparison With Existing Literaturementioning

confidence: 99%

Quality-assured screening for diabetic retinopathy delivered in primary care in Ireland: an observational study

Hugh

Buckley²,

Murphy³

et al. 2013

Br J Gen Pract

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“…Many patients do not take up the offer of screening. In Scotland, duration of diabetes, poor control, and smoking were associated with lower uptake;6 in Ireland and the Netherlands, individual recommendation by a healthcare professional increased participation 7,8. Patients’ lack of awareness, psychological factors (fear and guilt), or practical obstacles, such as obtaining time off work, were also important 9.…”

Section: Introductionmentioning

confidence: 99%

Influence of primary care practices on patients’ uptake of diabetic retinopathy screening: a qualitative case study

et al. 2014

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BackgroundThe NHS Diabetic Eye Screening Programme aims to reduce the risk of sight loss among people with diabetes in England by enabling prompt diagnosis of sight-threatening retinopathy. However, the rate of screening uptake between practices can vary from 55% to 95%. Existing research focuses on the impact of patient demographics but little is known about GP practice-related factors that can make a difference.AimTo identify factors contributing to high or low patient uptake of retinopathy screening.Design and settingQualitative case-based study; nine purposively selected GP practices (deprived/affluent; high/low screening uptake) in three retinopathy screening programme areas.MethodsSemi-structured interviews were conducted with patients, primary care professionals, and screeners. A comparative case-based analysis was carried out to identify factors related to high or low screening uptake.ResultsEight possible factors that influenced uptake were identified. Five modifiable factors related to service and staff interactions: communication with screening services; contacting patients; integration of screening with other care; focus on the newly diagnosed; and perception of non-attenders. Three factors were non-modifiable challenges related to practice location: level of deprivation; diversity of ethnicities and languages; and transport and access. All practices adopted strategies to improve uptake, but the presence of two or more major barriers made it very hard for practices to achieve higher uptake levels.ConclusionsA range of service-level opportunities to improve screening attendance were identified that are available to practices and screening teams. More research is needed into the complex interfaces of care that make up retinopathy screening.

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“…Despite the limitations of this study, the convenience sampling and reliance on self-report, findings highlight the role of health professionals in educating patients about the necessity of annual preventive care and the importance of category-specific recommendations [14,15]. For example, increases in annual foot examinations were not associated with participants who had health professional recommending eye checks; similarly, increases in annual eye examinations were not associated with participants who were told to have their feet checked in the final model.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with preventive care practice among adults with diabetes

Yuen

2012

Primary Care Diabetes

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Factors that influence the patient uptake of diabetic retinopathy screening

Abstract: It is essential that patients are fully aware of the need for a regular eye examination. Once a physician recommends this the screening rate improves.

Cited by 72 publications

References 23 publications

Quality-assured screening for diabetic retinopathy delivered in primary care in Ireland: an observational study

Quality-assured screening for diabetic retinopathy delivered in primary care in Ireland: an observational study

Influence of primary care practices on patients’ uptake of diabetic retinopathy screening: a qualitative case study

Factors associated with preventive care practice among adults with diabetes

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