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Anne Michael Langguth, Kathryn L Jackson, Dustin French, Michael Mbagwu, Paul Bryar; Demographic and Clinical Factors Associated with Diabetics Obtaining an Ophthalmologic Exam. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1587.
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© ARVO (1962-2015); The Authors (2016-present)
Diabetic retinopathy (DR) is a common cause of visual impairment in the United States. Annual eye exams are important in detecting and treating diabetic eye disease (DED). This study investigates factors associated with diabetics obtaining an ophthalmologic exam at a single institution.
Using the Northwestern Medicine Enterprise Data Warehouse, 7237 diabetic patients (with at least 2 primary care visits in the past 3 years at Northwestern) were identified with a 1-year look-forward period from their first diabetic diagnosis in the study period to evaluate for ophthalmologic screening. ICD-9 codes of 250.00-250.93 were used to identify all patients with DM; DED (diabetic retinopathy or macular edema) was defined as ICD-9 codes of 250.50-250.53, 357.2, 362.01-362.07, 364.42, and 366.41. The impact of the following factors on likelihood for patients with DM to receive an eye exam were assessed: race, gender, and HbA1c. Differences between groups were detected using chi-squared and ANOVA tests for categorical and continuous variables, respectively.
7237 adults with DM were identified. Mean age was 59.9 years; mean HbA1c 7.14%. 35.6% self-identified as Caucasian, 30.8% African-American, and 23.9% "Other" (10% did not report race). 8.2% of patients had DED. 29.8% received an ophthalmologic exam during the look-forward period. Eye exam rates were higher in those with DED compared to those without (76.5%, vs. 25.7%, p<0.0001). African-Americans were more likely to receive an eye exam than Caucasians (OR 1.29; CI [1.14,1.46]). Females were more likely to receive an eye exam than males (31.2% vs. 28.0%, p=.0046). Average HbA1c of patients not receiving an eye exam was 7.15%; average HbA1c of patients receiving an eye exam was 7.12%. This difference was not statistically significant.
In the patient population in our study, 30% of diabetics received an eye exam. Diabetics with DED are more likely to receive regular eye care than diabetics without DED, and differences in screening rates differ by race and gender. HbA1c level does not appear to influence the rate of receiving an annual eye exam. This information provides insight to healthcare providers in regards to promoting recommended ophthalmologic exams to patients with DM. Additional evaluation to determine rates of ophthalmologic care in patients with incident DM and influencing factors of these rates should be completed.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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