Eye screening guideline compliance among diabetic patients without diabetic retinopathy
Tuesday, November 5, 2013
: 10:30 a.m. - 10:45 a.m.
David Lee, PhD
, Epidemiology & Public Health, University of Miami, Miami, FL
Byron Lam, MD
, Bascom Palmer Eye Institute, University of Miami, Miami, FL
Cristina Fernandez, MSEd
, Department of Epidemiology and Public Health, University of Miami Miller School of Medicine, Miami, FL
Purpose: To estimate compliance with eye screening guidelines among people with diabetes mellitus (DM). Methods: Computerized billing records identified 248 patients initially seen in 2007-08 at our eye institute with ICD-9 diagnoses of DM without ocular complications. 203 charts were retrieved for follow-up visit review through 2010. Compliance was defined by follow-up exam frequency and permitted follow-up intervals of 15 months to accommodate scheduling challenges: (1) never returned (2) non-compliant but seen within last 15 months (3) non-compliant and not seen within last 15 months (4) compliant, returned for eye examination at least every 15 months. Results: After excluding 3 patients with diabetic retinopathy, 200 medical records were available for analysis. The N (%) patients in the four compliance groups were: 108 (54%), 30 (15%), 37 (19%), and 25 (12%), respectively. To date, 20 of the 108 patients who did not return for follow-up screenings completed a phone interview. Annual eye exams elsewhere were indicated by 14 (70%); 5 of 6 patients reporting no annual screening gave at least one of the following reasons: no time and/or not worried about their eyes (5/6), no insurance (3/6), no transportation (1/6). Telephone interviews are ongoing and a follow-up questionnaire mailing is planned for those not reached by phone. Conclusions: We found evidence that 19% (39) of patients are receiving annual (within 15 months) eye examinations. Findings to date suggest better access to health insurance and patient education may increase compliance rates.
Clinical medicine applied in public health
Describe diabetic compliance guidelines for diabetic patients without diabetic retinopathy. List some of the reasons that diabetic patients without diabetic retinopathy reported for not following the recommended screening guidelines. Evaluate the overall compliance to diabetic eye screening guidelines.
Presenting author's disclosure statement:
Qualified on the content I am responsible for because: I am the principal investigator under this grant and have been the PI or co-PI on numerous other federally funded grants regarding diabetic retinopathy and eye screening.
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.