Abstract
Purpose :
To determine the adherence to diabetic eye examination guidelines in Indigenous and non-Indigenous Australians
Methods :
Design: A cross-sectional survey using multi-stage, random cluster sampling.
Setting: Thirty randomly selected geographic sites in five Australian states and one Territory, stratified by remoteness.
Participants: 1738 Indigenous Australians aged 40-92 years and 3098 non-Indigenous Australians aged 50-98 years were recruited and examined between March 2015 and April 2016. Participants were examined using a standardised protocol that included a questionnaire (interviewer administered) a series of standardised eye tests.
Main outcome measures: National Health and Medical Research Council (NHMRC) diabetic eye examination guidelines were used to determine adherence.
Results :
Non-Indigenous Australians had a significantly higher adherence to screening recommendations (biennial screening) than Indigenous Australians (annual screening) (77.5% vs 52.7%, p <0.001). Factors associated with greater adherence were longer duration of diabetes in non-Indigenous Australians (OR 1.19 per five years, p=0.018) and male gender (OR 1.46, p=0.018) and residing in Inner Regional geographic areas (OR 1.66, p=0.007) in Indigenous Australians (OR=0.44, p=0.018). Older age was associate with poorer adherence in non-Indigenous Australians (OR 0.70 per decade, p=0.010).
Conclusions :
More than three quarters of non-Indigenous Australians with diabetes and more than half of Indigenous Australians with diabetes adhere to the NHMRC eye examination guidelines. The discrepancy between adherence rates in Indigenous and non-Indigenous communities may point to a gap in the provision or uptake of screening services in Indigenous communities or a lack of awareness of the guidelines. A carefully integrated diabetic retinopathy screening service is required, particularly in remote areas, to improve adherence rates.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.