Effectiveness of a clinic-based intervention to improve follow-up adherence to vision care in patients with diabetes
Tuesday, November 5, 2013
: 11:00 AM - 11:15 AM
Introduction: Diabetic retinopathy is the leading cause of blindness among adults aged 20-74 years. However, only about 50% of diabetics follow up with recommended dilated fundus examinations (DFE). Therefore, we implemented a clinic-based intervention to improve adherence to DFEs among these patients. Methods: In a randomized trial, diabetic patients who were due for a follow-up DFE, were assigned to receive 1) a single-mailed reminder letter (control group) or 2) a clinic-based intervention that consisted of a reminder letter plus an educational brochure, followed by a telephone call to schedule the DFE. Barriers to care utilization were captured. The primary outcome was completion of a DFE. Results: 522 patients were randomly assigned (control group n=260, intervention group n=262). Participants in both groups were similar with regards to gender, race, and age; female (66%), African-American (70%), mean age (61 years). Patients in the intervention group were more likely to schedule an appointment (68% vs. 44%; relative risk 1.55; 95% confidence interval 1.29-1.79; p <0.0001) compared to controls. Patients in the intervention group were equally likely to keep their appointment once scheduled compared to the control group (73.3% vs. 71.3%; p =0.71). Among those who did not make an appointment, common reported barriers included lack of time due to appointments for other medical conditions and no health insurance. Conclusions: A clinic-based intervention, which includes reminder letters, educational brochure, and appointment calls, significantly improves DFE adherence in patients with diabetes.
Administer health education strategies, interventions and programs
Chronic disease management and prevention
Implementation of health education strategies, interventions and programs
Demonstrate the effectiveness of an intervention to increase rates of eye examination and improve adherence to eye care recommendations.
Describe the clinic-based intervention in order to be replicable to other vision care clinics.
Identify barriers that prevent people from adhering to vision care recommendations.
Keywords: Diabetes, Vision Care
Presenting author's disclosure statement:
Qualified on the content I am responsible for because: I am an ophthalmologist and MPH candidate working as a Research Fellow at the Wills Eye Institute. The focus of my work has been to increase adherence to eye care recommendations and increase access to eye care.
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.