Abstract
Purpose :
The American Academy of Ophthalmology recommends annual eye exams beginning five years after diagnosis for those with type 1 diabetes, and immediately after diagnosis for those with type 2 diabetes. This is important as inconsistent clinical follow-up has been associated with poor visual outcomes. In this retrospective study, we examine social factors that are associated with visit adherence among those diagnosed with diabetic retinopathy.
Methods :
A cohort of patients diagnosed with diabetic retinopathy of any type was obtained, including non-proliferative and proliferative diabetic retinopathy retinopathy from the NIH All of US Research Program – a large nationwide EHR-based database with linked survey elements. Answers from the latest Healthcare Access and Utilization survey were used. Our cohort was split into two groups, those who have seen an eye doctor in the previous 12 months, and those who have not. Pearson’s Chi-squared tests were used to compare demographic and survey responses between groups. Statistical tests were two-sided, and p-values were considered statistically significant at the α = 0.05 level.
Results :
Of the 1818 diabetic retinopathy patients in our cohort, 1518 (83.5%) saw an eye doctor in the previous 12 months while 300 (16.5%) did not. Demographic factors significantly associated with not seeing an eye doctor in the prior 12 months included younger age (P<0.001), female gender (P=0.004), non-White race (P<0.001), birthplace outside of USA (P<0.001), lower education (P<0.001), lower income (P<0.001), and Medicaid insurance status (P<0.001). Social factors significantly associated with not seeing an eye doctor in the prior 12 months included not having transportation (P=0.002), not being able to afford follow-up care (P<0.001), stable housing concern (P=0.015), and not feeling respected by your provider (P<0.001).
Conclusions :
Factors associated with not seeing an eye doctor in the previous 12 months among those diagnosed with diabetic retinopathy include economic barriers such as income, insurance status, transportation and housing concerns, but also social factors such as not feeling respected by your provider. As regular eye exams are essential to monitoring the progression of diabetic retinopathy and providing early treatment and counseling, eye care providers and greater healthcare systems should work to mitigate these barriers to care.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.