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Suruchi Bhardwaj, Rachel Anderson, Bing Chiu, David Eppenstein, Kenneth J Wald, Joseph J Tseng, Yasha Modi; Evaluation of Compliance Rates in Patients with Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1052.
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© ARVO (1962-2015); The Authors (2016-present)
To study the clinic attendance rates and comorbidities in patients with and without diabetic retinopathy
We conducted a retrospective review of all patients scheduled and attended a retina practice between January 2016 - December 2016. Patient charts were divided into nondiabetics, non-proliferative diabetic retinopathy(NPDR), and proliferative diabetic retinopathy(PDR). Attendance rate was calculated for non-diabetic patients and diabetic patient groups. Additional data collected included: history of prior laser procedures(PRP, focal),history of intra-vitreal injections, presence of DME, comorbidities including HTN,HLD,CVD requiring stent or surgery,CKD requiring dialysis, history of amputation, smoking status. Predictive factors for noncompliance were assessed.
There were 14,550 scheduled visits (10344 nondiabetics and 4206 diabetics). The no show rate for nondiabetics was 13.8% and was 10.2% for all diabetics. A subgroup analysis of a total of 1038 diabetic retinopathy patients (484 NPDR, 554 PDR) with 2978(1061 NPDR, 1917 PDR) visits were reviewed, with an overall no show rate of 10.5% in NPDR and 9.3% in PDR. There is a nonsignifiant trend towards higher attendance rates in patients with more scheduled visits (89.3% for 1-3, 92.1% for 4-6, and 93.2% for 7 or more scheduled visits; one-way ANOVA,F=2.06, p=0.13). There is a nonsignificant trend of increasing number of comorbidities associated with higher rates of no show visits (9.4% for 0, 7.9% for 1,10.7% for 2, 11.6% for 3, and 7.7% for 4 comorbidities). Smoking did not significantly affect show rates (nonsmokers 10.4%,former 8.0%,current 8.5%). Higher no show rates are found in NPDR and PDR patients with prior treatment with focal laser (13.4%vs7.8% for NPDR, p=0.013 and 12.1%vs8.7%,P=0.026). Prior treatment with anti-VEGF injections were associated with lower no show rates (6.5%vs10.5%, P< 0.05).
Contrary to physician bias, patients without diabetes and those with varying degrees of diabetic retinopathy did not demonstrate differing levels of clinic attendance. Additionally, as the scheduled visits increased, patients with diabetic retinopathy were more likely to show, although this was not statistically significant. Medical comorbidities demonstrated a nonsignificant trend towards lower compliance with clinic attendance, which is important to reconcile when deciding a treatment paradigm.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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