260920 Long-term comparative effectiveness of telemedicine to detect diabetic retinopathy

Monday, October 29, 2012 : 3:30 PM - 3:50 PM

Steven Mansberger, MD, MPH , Legacy Health, Devers Eye Institute, Portland, OR
Christina Sheppler, PhD , Legacy Health, Devers Eye Institute, Portland, OR
Cory VanAlstine, BA , Legacy Health, Devers Eye Institute, Portland, OR
Stuart Gardiner, MA, CASM, PhD , Legacy Health, Discoveries in Sight/Devers Eye Institute, Portland, OR
Thomas Becker, MD, PhD , Department of Public Health & Preventive Medicine, Oregon Health & Science University, Portland, OR
BACKGROUND: Diabetic retinopathy is the leading cause of new cases of blindness in adults aged 20-74. Without treatment, diabetic retinopathy can progress from being asymptomatic in its early stages, to permanent visual impairment in its later stages. It is recommended that diabetics have an eye exam each year to screen for the presence of retinopathy, but less than 50% of those diagnosed with diabetes obtain annual eye exams. This low screening proportion is even worse for minority and rural patients. METHODS: The researchers partnered with two tribal health clinics in Oregon and Kansas to focus on screening for diabetic retinopathy. Participants were randomly assigned to either telemedicine (digital images of the retina were captured in the clinic with a nonmydriatic camera and sent electronically to an eye care provider for evaluation) or traditional surveillance (annual eye exams in an eye care provider's office). Participants also completed two surveys created for this study: The Compliance with Annual Diabetic Eye Exams (CADEES) Survey and a Cost-Effectiveness Survey. RESULTS: Last year baseline results were reported. This year the researchers will report on (1) long-term effectiveness of telemedicine to detect diabetic retinopathy when compared to traditional surveillance methods, (2) health belief factors associated with adherence to annual eye exams, and (3) cost-effectiveness of the telemedicine system from the perspective of the community clinic, the third-party payer, and the patient. CONCLUSION: This data will be presented to policy makers to encourage change in the national and state guidelines regarding the delivery of diabetic eye exams.

Learning Areas:
Public health or related research

Learning Objectives:
1. Explain why it is important for diabetic patients to have eye exams on an annual basis. 2. Discuss why telemedicine has the potential to increase the proportion of diabetic patients that receive annual eye exams.

Keywords: Vision Care, Telemedicine

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an Associate Scientist and the Director of Glaucoma Services and Ophthalmic Clinical Trials for Devers Eye Institute in Portland, Oregon. I hold an appointment at Oregon Health & Science University as a Clinical Associate Professor of Ophthalmology and Public Health and Preventive Medicine. I have had research grant support from the National Eye Institute and the Centers for Disease Control and Prevention, and I have authored over 100 articles, book chapters, and abstracts.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.