Modelling the cost‐effectiveness of adopting risk‐stratified approaches to extended screening intervals in the national diabetic retinopathy screening programme in Scotland

Scotland, Graham; Philip, Sam; Leese, Graham; Olson, John A.; Looker, Helen C.; Colhoun, Helen M.; Javanbakht, Mehdi

doi:10.1111/dme.13129

Cited by 11 publications

(11 citation statements)

References 29 publications

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“…Moreover, adopting biennial screening approach, a reduction in approximately 25% of screening costs can be obtained without increased risk to the patient [44]. Two recent studies reported cost-effectiveness of adopting risk-stratified approaches to extended screening intervals in the national DR screening programs in England and Scotland [45, 46]. Scanlon et al conducted a modelling study and reported that for patients without DR on two consecutive screening examinations the adoption of 2-year screening intervals would save on average 225000 pounds per QUALY (quality-adjusted life years) lost compared with annual screening in England [45].…”

Section: Telemedicine Screening Programs In Italymentioning

confidence: 99%

“…Scanlon et al conducted a modelling study and reported that for patients without DR on two consecutive screening examinations the adoption of 2-year screening intervals would save on average 225000 pounds per QUALY (quality-adjusted life years) lost compared with annual screening in England [45]. Scotland et al reported similar results for patients with T2DM and lower increment in cost-effectiveness ratios for patients with T1DM (85000 pounds) per QUALY gained [46]. …”

Section: Telemedicine Screening Programs In Italymentioning

confidence: 99%

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Diabetic Retinopathy in Italy: Epidemiology Data and Telemedicine Screening Programs

Vujosevic

Midena

2016

Journal of Diabetes Research

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In Italy, the number of people living with diabetes is about 3.5 million (5.5% of the population), with an increase by about 60% in the last 20 years and with 1 person out of 3 older than 65 years. The Italian Health Service system estimates that 10 billion euros is spent annually on caring for patients with diabetes, a figure that increases yearly. No national data on prevalence and incidence of legal blindness in patients with diabetes and no national registry of patients with diabetic retinopathy (DR) are currently available. However, the available epidemiological data (in several locations throughout the country) are consistent with those reported in other European countries. The use of telemedicine for the screening of DR in Italy is confined to geographically limited locations. The available data in the literature on implementation and use of telematic screening proved to be successful from patient, caregiver, and authorities point of view. This review addresses the available epidemiological data on DR and telematic screening realities in Italy and thus may help in establishing a national screening program.

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Section: Telemedicine Screening Programs In Italymentioning

confidence: 99%

Section: Telemedicine Screening Programs In Italymentioning

confidence: 99%

Diabetic Retinopathy in Italy: Epidemiology Data and Telemedicine Screening Programs

Vujosevic

Midena

2016

Journal of Diabetes Research

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“…As DR is a multiprofessional and a multidimensional eye disease, a multidisciplinary group was involved in the project, including general practitioners, diabetes experts, administrative staff, nurses, epidemiologists, and ophthalmologists. The involvement of different healthcare professionals in the screening programme could influence the resources absorption and the optimisation of the screening pathway [12, 13, 16–18]. …”

Section: Methodsmentioning

confidence: 99%

“…The application of these new screening programmes, followed by prompt diagnosis and a better timely management, is well known to prevent significantly the risk of diabetic blindness [9, 10], as well as to decrease all the costs related to the investigated pathology. In fact, from an economic point of view, the annual cost per patient affected by DR is approximately twice as high as those patients with diabetes only [11]: thus, the implementation of effective and recognized screening programmes could represent cost-effective strategies [12, 13], one useful to narrow both the economic and the social burden of DR.…”

Section: Introductionmentioning

confidence: 99%

The Nonmydriatic Fundus Camera in Diabetic Retinopathy Screening: A Cost-Effective Study with Evaluation for Future Large-Scale Application

Scarpa

Urban

Vujosevic

et al. 2016

Journal of Ophthalmology

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Aims. The study aimed to present the experience of a screening programme for early detection of diabetic retinopathy (DR) using a nonmydriatic fundus camera, evaluating the feasibility in terms of validity, resources absorption, and future advantages of a potential application, in an Italian local health authority. Methods. Diabetic patients living in the town of Ponzano, Veneto Region (Northern Italy), were invited to be enrolled in the screening programme. The “no prevention strategy” with the inclusion of the estimation of blindness related costs was compared with screening costs in order to evaluate a future extensive and feasible implementation of the procedure, through a budget impact approach. Results. Out of 498 diabetic patients eligible, 80% was enrolled in the screening programme. 115 patients (34%) were referred to an ophthalmologist and 9 cases required prompt treatment for either proliferative DR or macular edema. Based on the pilot data, it emerged that an extensive use of the investigated screening programme, within the Greater Treviso area, could prevent 6 cases of blindness every year, resulting in a saving of €271,543.32 (−13.71%). Conclusions. Fundus images obtained with a nonmydriatic fundus camera could be considered an effective, cost-sparing, and feasible screening tool for the early detection of DR, preventing blindness as a result of diabetes.

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“…One of diabetes’ costliest aspects involves the detection and treatment of its complications [4, 5]. In Australia, Wright et al, studied a hypothetical patient with blindness due to diabetic retinopathy (DR) and estimated the direct annual cost incurred by both the government and community would be $17,701 (range $9669–26,720) [6].…”

Section: Introductionmentioning

confidence: 99%

Screening for Diabetic Eye Disease among Samoan Adults: A Pilot Study

et al. 2017

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IntroductionThe purpose of this study was to determine the prevalence of diabetic retinopathy in Samoa by piloting a retinal photography screening programme.MethodsWe performed a cross-sectional study of patients with diabetes who presented to the Tupua Tamasese Meaole eye clinic in Apia, Samoa, between May 2011 and September 2011. Study approval was granted by the National Health Service Board of Samoa, the Monash University Human Research Ethics Committee, and the study adhered to the Tenets of the Declaration of Helsinki. Following informed consent, data collection included patient demographics [age, area of residence (rural or urban)], type of diabetes, length of time since diagnosis, most recent random blood sugar and blood pressure levels. The subjects had three 45-degree retinal photographs taken in each eye with the Canon CR6-45NM camera. All gradable photographs were assessed for the presence of diabetic retinopathy or macular oedema using the International Clinical Diabetic Retinopathy Severity Scale and the International Clinical Diabetic Macular Oedema Severity scale, respectively.ResultsTwo hundred and fourteen eyes from 107 subjects were examined during the study period, all of whom had type 2 diabetes mellitus. Diabetic retinopathy was present in 53.3% (114/214) of eyes, with 14.5% having proliferative retinopathy and 7.5% with severe non-proliferative retinopathy. Also, 25.2% (54/214) had some evidence of macular oedema with 11.7% (25/214) requiring treatment. A statistically significant relationship existed between the length of time since diagnosis and the severity of both retinopathy (p < 0.001) and macular oedema (p = 0.031). Blood pressure more than 150/85 mmHg was associated with higher levels of diabetic retinopathy (p = 0.03) and macular oedema (p = 0.02).ConclusionA comprehensive diabetic retinopathy screening programme is much needed in Samoa given the high prevalence of diabetic eye disease.

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Modelling the cost‐effectiveness of adopting risk‐stratified approaches to extended screening intervals in the national diabetic retinopathy screening programme in Scotland

Cited by 11 publications

References 29 publications

Diabetic Retinopathy in Italy: Epidemiology Data and Telemedicine Screening Programs

Diabetic Retinopathy in Italy: Epidemiology Data and Telemedicine Screening Programs

The Nonmydriatic Fundus Camera in Diabetic Retinopathy Screening: A Cost-Effective Study with Evaluation for Future Large-Scale Application

Screening for Diabetic Eye Disease among Samoan Adults: A Pilot Study

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