Does patient education improve compliance to routine diabetic retinopathy screening?

Abstract

Introduction Diabetic retinopathy (DR) screening relies on adherence to follow-up eye care. This article assesses if a model of patient education and tele-retina screening among high-risk patients with DR can achieve increased rates of compliance within a one-year follow-up. Methods Between May 2014 and May 2016, DR screening was conducted in a cohort of 101 patients with diabetes in Southern Ontario. Optical coherence tomography and fundus photography images were used to visualize the retina remotely. Enrolled patients participated in an educational seminar at the screening site with the expressed purpose of enhancing patient understanding of DR. A chi-squared test was used to assess patient compliance to follow-up examinations within 6–12 months, while pre-to post-screening HbA1c levels were compared using a dependent t-test. Results Of 101 patients who completed the study, 33 patients (32.6%) have never previously been screened for DR. Baseline compliance to annual screening increased from 36 patients (35.6%) to 51 patients (50.5%) after the tele-retina programme ( p = 0.03). Eighty-nine patients (88%) were referred to an optometrist for ongoing care compared with 12 patients (11.9%) to an ophthalmologist for management of DR. Overall, 100 patients (99.0%) were satisfied with the tele-retina screening. There was no significant change in pre- to-post screening HbA1c levels ( p = 0.91). Discussion Patient education-focused tele-retina screening for DR significantly increased compliance to follow-up in a high-risk, non-compliant patient population. Management of diabetes as captured by HbA1c levels remain unchanged in the cohort indicating a need for ongoing inter-professional collaboration in education and vision screening.

What conservative interventions improve bite function in those with temporomandibular disorders? A systematic review using self‐reported and physical measures

“…In other musculoskeletal populations, evidence for patient education alone in management is conflicting. [34][35][36][37][38][39] Instead, it is often advocated for within a multi-modal regime. In this way, patient education has been shown to help improve patient understanding and self-efficacy and reduce pain, disability, and catastrophising.…”

“…Another important consideration is that patient education was often delivered alone as a ‘control’ intervention. In other musculoskeletal populations, evidence for patient education alone in management is conflicting 34‐39 . Instead, it is often advocated for within a multi‐modal regime.…”

Health education improves referral compliance of persons with probable Diabetic Retinopathy: A randomized controlled trial

“…Our multicomponent and locally adapted intensive health education intervention succeeded to attain a referral compliance rate that was 36.1% higher (in other words, this is equivalent to 128% increase in interventions group compared to control group). Several RCTs based in developed countries that used varied health education modalities to increase DFE reported a lower compliance rate [21,[31][32][33][34][35][36][37]. Apart from the fact that a multicomponent intervention was used in our study, there may be other reasons why it was possible to attain higher compliance rate compared to other global studies.…”

Knowledge outcome of visual-simulation-based over print-based diabetic retinopathy health education amongst the Omani community residing in Al Batinah, Oman

“…9,12,16 Further studies on recent DR health educational advancements through mobile health 5 or a study based on telemedicine platforms for patient screening, accompanied by health education have also observed a similar pattern. 17 However, it is important to evaluate the impact of different health-education methods suitable to the community to yield the optimum programme outcome. Hence, this study helps in filling the evidence gap regarding the different educational interventions focusing on DR.…”