Augmenting the Referral Pathway for Retinal Services Among Patients With Diabetes Mellitus at Reiyukai Eiko Masunaga Eye Hospital, Nepal: Protocol for a Nonrandomized, Pre–Post Intervention Study (Preprint)

Abstract

BACKGROUND Diabetic Retinopathy (DR) is an important public health issue in Nepal with a huge social and economic impact. Despite the availability of retinal services, people may not access them because of the lack of knowledge about DR and poor referral systems. Published studies on referral pathways in Nepal are scarce. Improving DR awareness among general physicians has the potential to address these challenges. OBJECTIVE Objectives: To see the effect of the health education intervention in health personnel and establish a referral pathway, on the attendance of diabetic patients for retinal screening at Reiyukai Eiko Masunaga Eye Hospital (REMEH), Nepal. METHODS This is a non-randomized, pre-post intervention study design. Health education will be provided on diabetic retinopathy to selected health personnel of the intervention (Scheer Memorial) Hospital using Information Education and Communication (IEC) materials in the form of PowerPoint presentations, posters, pamphlets, videos, pre, and post-evaluation questionnaire along with referral slip. Pre and post evaluation will be undertaken during the study period. Data will be analyzed using Excel and Epi Info 7. RESULTS The study is expected to complete in 18 months from the start of the project. CONCLUSIONS Health education intervention could be a low-cost solution to improve the awareness, access, utilization of retinal health care services; this is an understudied topic in Nepal. Working closely with the stakeholders, this study will evaluate the role of health education interventions (which are already validated in other low-income settings) to strengthen referral and reduce the burden of DR in Nepal.