Demographic and health belief variables associated with adherence to annual diabetic eye exams

BACKGROUND: Diabetic retinopathy is the leading cause of blindness in adults aged 20-74; however, early diagnosis and treatment can reduce the likelihood of severe vision loss by up to 90%. 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. METHODS: As part of a larger study, participants completed the Compliance with Annual Diabetic Eye Examination Survey (CADEES). This survey contains items that measure demographics, health beliefs, and eye exam history. RESULTS: Participants (n=316) were 46% male and ranged in age from 24 to 83 years (M=55.7, SD=11.6). Adherence was defined as having a dilated eye exam in the past 12 months. Univariate tests showed that adherence was significantly associated with longer duration of diabetes (p<.01), lower Hemoglobin A1c levels (p=.02), increased age (p<.01), and having insurance coverage (p<.01); adherence was not related to income, sex, marital status, or education. Based on univariate results, 16 health belief items were identified as potential predictors of adherence. A logistic regression model containing these variables showed that beliefs about (a) whether insurance covers most the cost of an eye exam (p=.02), (b) whether getting an eye exam was a priority (p=.02), and (c) general barriers that make obtaining eye exams difficult (p=.04) were significant predictors of adherence. CONCLUSION: The CADEES shows promise for predicting adherence with yearly diabetic eye exams. Further research is needed to confirm these results and refine the survey.