Purpose
Patient adherence to long-term treatment is key to reduction of visual impairment from diabetic retinopathy (DR). We conducted a prospective, randomized intervention to evaluate if eye fundus photography enhanced health talks (PEHT) would improve patient adherence to follow-up examination instructions compared to non-enhanced health talks (NEHT).
Methods
We enrolled all the 373 diabetic participants that visited one of four different locations in Asuncion, Paraguay (?) from November 2013 to June 2014.<br /> After an initial examination and collection of demographic and socioeconomic data, patients were given a standardized health talk about the importance of treatment compliance and not missing follow-up consultations. They were randomized to receive the NEHT or PEHT. Participants were then asked to return for a follow-up examination according to a previously established schedule based on their diabetic retinopathy stage (graded by experienced personnel).
Results
After randomization, 193 participants (51.7%) were assigned to PEHT and 180 (48.3%) to NEHT. The distribution of DR classification was similar in both groups (p=0.26). 23 (11.9%) participants in the PEHT and 19 (10.6%) participants in the NEHT required a follow up examination within x weeks. In the PEHT group, 12 out of 23 participants (52.2%) returned as scheduled, while in the NEHT, 10 out of 19 participants (52.63%) returned (p=0.95). When analyzed by DR classification, only X participants classified as having Grade 3 DR had increased adherence in the PEHT group (NEHT x/y = z%, PEHT w/t = v%, p=0.014).<br /> <br /> <br /> <br />
Conclusions
In patients with advanced DR, PEHT may increase compliance to diabetic eye follow up examinations. Using PEHT does not appear to increase patient adherence to follow up instructions in those with early disease