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Rajeev Ramchandran; Camera based screening in diabetic retinopathy at primary care clinics. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1198. doi: https://doi.org/.
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Presentation Description :
Diabetic retinopathy (DR) is the leading cause of new-onset blindness in working age US adults. About 95% of blindness as a result of DR can be prevented by early detection and treatment. This can be achieved during annual dilated eye exams. However, patient compliance with DR screening through annual dilated eye exam is less than 50%. To address this, multiple teleophthalmology programs for DR have been developed and implemented across the US. In this study, we conducted a formative evaluation of the implementation process and sustainability of teleophthalmology DR screening services based on implementation science frameworks. Three focus groups and individual patient interviews were conducted with a total of 23 patients across two primary care clinics. Patients were grouped based on care: dilated or camera-screened. Patients completed a questionnaire measuring perspectives on the importance of getting an annual dilated eye exam or the option of getting a DR camera-screening at primary care doctor’s office, respectively. Focus groups and interviews provided patient-related themes concerning convenience and continuity of care, having trusting relationships with the primary care doctor, insurance coverage, and the knowledge of detrimental effects of DR on vision. The main barriers reported were lack of transportation, proximity of care, ambiguity around cost of camera-screening, and lack of confidence in the screening being effective in conveying problems. In parallel interviews of staff where camera based screening for diabetic retinopathy were questioned on the implementation, process, and utility of camera based screening for retinopathy in their diabetic patients. Findings suggest that better communication about the knowledge of detrimental effects of DR on visual acuity may help to increase eye care utilization among diabetic patients with high risk for advancing eye disease and vision loss. In addition, staff training and usability of the non-mydriatic camera for screening along with more engagement of patients by the screening service were determined as important points that would improve the program.
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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