June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Reported barriers to obtaining eye exams among patients with diabetes in the All of Us dataset.
Author Affiliations & Notes
  • Brandon Grover
    University of Wisconsin-Madison College of Letters and Science, Madison, Wisconsin, United States
  • Roomasa Channa
    University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, United States
  • Mozhdeh Bahrainian
    University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, United States
  • Footnotes
    Commercial Relationships   Brandon Grover None; Roomasa Channa None; Mozhdeh Bahrainian None
  • Footnotes
    Support  National Eye Institute
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 2278. doi:
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      Brandon Grover, Roomasa Channa, Mozhdeh Bahrainian; Reported barriers to obtaining eye exams among patients with diabetes in the All of Us dataset.. Invest. Ophthalmol. Vis. Sci. 2023;64(8):2278.

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

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Abstract

Purpose : For individuals with diabetes mellitus (DM), eye exams allow timely detection and treatment of diabetes-related eye disease and minimize the risk of vision loss. However, adherence to eye exams is poor. Therefore, we sought to determine factors associated with the receipt of eye exams among individuals with DM using national-level survey data from the All of Us (AoU) dataset.

Methods : We used diagnosis, procedure codes, and self-reported data to identify individuals with DM and whether they had undergone an eye exam. We evaluated factors including demographics, and data from surveys which included questions about level of education, insurance coverage, insurance rejection, lack of transportation, living in a rural location, having to provide dependent care, if able to get time off from work, race and religious discordance with a healthcare provider, if saw an optometrist, ophthalmologist or eye doctor for their health, levels of stress, feelings of isolation, identifying cost as a barrier, healthcare advice, and food insecurity. Seventeen questions identifying cost as a barrier were incorporated into a single variable. Similarly, ten questions asking if saw a healthcare provider (one per question, ten total) for their health were collapsed into a single variable, and two questions involving food insecurity were a single variable. Factors significant on univariable analysis were included in a multivariable logistic regression analysis (p<0.05).

Results : At the time of our analysis, there were over 369,000 adult participants in the AoU dataset. We identified 51,561 adult participants with DM: 16,630 (32.3%) had, and 34,931 (67.7%) had not received an eye exam. There were no significant differences in gender, race, or ethnicity of participants who did and did not have an eye exam. Factors significant on multivariable logistic regression for not obtaining an eye exam were younger age (60.1 years vs. 65.4 years; p<0.001), an inability to afford adequate care (50.6% vs. 44.1%; p=0.008), and insurance rejection (11.2% vs. 8.5%; p=0.011).

Conclusions : The data from a nationwide analysis revealed that over two-thirds of individuals with DM had not had an eye exam. Cost was identified as a significant barrier to receiving routine eye exams among individuals with DM. This barrier indicates the need to develop and promote more cost-effective screening eye exam options for individuals with diabetes.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

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