June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Factors associated with follow up to eye care after teleophthalmology evaluation of diabetic patients
Author Affiliations & Notes
  • Ernesto Sabogal
    Medical School, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States
  • Jesica Basant
    Ophthalmology, University of Rochester Medical Center, Rochester, New York, United States
  • Hamza Sadhra
    Medical School, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States
  • Derek Guo
    Public Health Sciences, University of Rochester Medical Center, Rochester, New York, United States
  • Denes Szekeres
    Medical School, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States
  • Scott McIntosh
    Public Health Sciences, University of Rochester Medical Center, Rochester, New York, United States
  • Deborah Ossip
    Public Health Sciences, University of Rochester Medical Center, Rochester, New York, United States
  • Keiwan Wind
    Ophthalmology, University of Rochester Medical Center, Rochester, New York, United States
  • Robert Fortuna
    Internal Medicine, University of Rochester Medical Center, Rochester, New York, United States
  • Matthew Devine
    Family Medicine, University of Rochester Medical Center, Rochester, New York, United States
  • Katherine Hazen
    Internal Medicine, University of Rochester Medical Center, Rochester, New York, United States
  • Soumya Sridhar
    Family Medicine, University of Rochester Medical Center, Rochester, New York, United States
  • Rick Warrington
    Ophthalmology, University of Rochester Medical Center, Rochester, New York, United States
  • Matthew Quick
    Public Health Sciences, University of Rochester Medical Center, Rochester, New York, United States
  • Manpreet Kaur
    Public Health Sciences, University of Rochester Medical Center, Rochester, New York, United States
  • Rajeev S Ramchandran
    Ophthalmology, University of Rochester Medical Center, Rochester, New York, United States
  • Footnotes
    Commercial Relationships   Ernesto Sabogal None; Jesica Basant None; Hamza Sadhra None; Derek Guo None; Denes Szekeres None; Scott McIntosh None; Deborah Ossip None; Keiwan Wind None; Robert Fortuna None; Matthew Devine None; Katherine Hazen None; Soumya Sridhar None; Rick Warrington None; Matthew Quick None; Manpreet Kaur None; Rajeev Ramchandran None
  • Footnotes
    Support  local Grants from Greater Rochester Health Foundation, Excellus BC/BS community grant, Accountable Health Partners Population Health Grant.
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 1400 – A0096. doi:
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      Ernesto Sabogal, Jesica Basant, Hamza Sadhra, Derek Guo, Denes Szekeres, Scott McIntosh, Deborah Ossip, Keiwan Wind, Robert Fortuna, Matthew Devine, Katherine Hazen, Soumya Sridhar, Rick Warrington, Matthew Quick, Manpreet Kaur, Rajeev S Ramchandran; Factors associated with follow up to eye care after teleophthalmology evaluation of diabetic patients. Invest. Ophthalmol. Vis. Sci. 2022;63(7):1400 – A0096.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To report on demographic and systemic health related factors associated with follow-up eye care for diabetic patients from safety net primary care clinics in one health system who received a teleophthalmology evaluation.

Methods : A retrospective analysis on prospectively obtained cross sectional data for patients who underwent teleophthalmology evaluation at six urban safety net primary care clinics from 2015-2021 was performed. Demographic factors included age, race, ethnicity, sex, and health insurance. Systemic health factors included BP, smoking status, HbA1c, level of diabetic retinopathy (DR) and distance VA. Patients diagnosed with DR post screening were identified as having vision threatening (VTDR) (presence of diabetic macular edema (hard exudates), severe non-proliferative DR or worse) or non-vision threatening DR (NVTDR). Predictor variables associated with dependent variables at p<0.20 were included in single and multivariate logistic regressions at a p<0.05 significance level.

Results : Of patients (n=1229) evaluated via teleophthalmology, 702 (57%) scheduled follow up eye care appointments. 396 (56%) patients kept their appointments.

More African Americans (62%) made appointments than whites (49%), or those classified as other races (59%) (p<0.001). More Hispanics (62%) made appointments than non-Hispanics (56%) (p<0.05). Medicare Advantage (59%) (p<0.006), Medicare/Medicaid (62%) (p<0.02), and Medicaid managed plan holders (62%) (p<0.003) were more likely to make appointments than the uninsured (44%). More patients with VTDR (79%) (p<0.001) or NVTDR (66%) (p<0.05) made appointments than those without DR (55%).

Older age (p<0.02) was associated with keeping appointments. More nonsmokers (61%) (p<0.03) kept appointments than smokers (51%). More Medicare insurance plan holders (59%) kept appointments than commercial plan holders (51%) (p<0.03). VTDR (p=0.19) and NVTDR (p=0.30) patients were not more likely to keep appointments than those without DR.

Conclusions : Follow-up to eye care following primary care based vision screening and telehealth evaluation for retinopathy in patients with diabetes remains a challenge. Patients diagnosed with DR were more likely to make but not keep follow up appointments. More support to increase appointment adherence in low income, safety net patients is required, especially if they are younger, smoke, or have commercial insurance.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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