Abstract
Purpose :
Identifying patients with mild diabetic retinopathy (DR) and macular edema (DME) is key to early disease management. In Australia, ca. 3 million people will be diagnosed with diabetes by 2025, leading to increased incidence of DR/DME (Tapp et al 2003). Despite guidance on referral of patients to retinal screening, only 50% of eligible patients receive recommended care (Foreman et al 2017). In 2016, Medicare Australia introduced initiatives to enhance DR screening in primary care, projected to cover 400,000 people, but only 8,000 people accessed these services between 2016 and 2020 (Medicare Australia report, 2021). RANZCO's guidance (2020) includes greater engagement with patient associations and building closer links between retinal physicians and optometrists.
Methods :
Clinical trials targeting this population provide a useful framework to increase contact between patients and practitioners. Here we present a novel strategy to improve the identification/enrolment of patients with mild DR/DME into a phase 1b trial (NCT04565756).
The enrolment strategy for this trial initially targeted retinal specialists, but this resulted in significantly slow recruitment due to the poor representation of these patients in specialist clinics. The decision was then taken to diversify patient engagement : (1) by collaborating with the national diabetes patient organisation, Diabetes Australia (DA), and (2) by building stronger digital links between optometrists and the trial sites.
Results :
DA has built reach to more than 1.5 million diabetic patients across the country. Information about the trial was shared through a weekly newsletter to all its members.
Links between optometrists and sites were achieved using the Oculo digital platform. Oculo is a cloud-based referral and clinical communications platform launched in 2016 that is used by most private eye care professionals in Australia.
Once these initiatives were implemented, patient identification, screening and enrolment grew by 30%, with a total contribution of 8 patients out of 35 enrolled, resulting in a much shorter recruitment timeline.
Conclusions :
This Australia-first hybrid engagement strategy building connections across the patient pathway, provides a useful template to accelerate recruitment of mild DR/DME patients into trials and facilitate better access to treatment for these patients.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.