Socioeconomic factors associated with visual impairment and ophthalmic care utilization in patients with type II diabetes

Hwang, Jongnam; Rudnisky, Christopher J.; Bowen, Sarah; Johnson, Jeffrey

doi:10.1016/j.jcjo.2014.11.014

Cited by 33 publications

(35 citation statements)

References 40 publications

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“…Themes: Financial concerns (27 studies) and consequences of private insurance (five studies). Financial concerns, such as the cost of the eye examination/care and the cost or lack of insurance were common, especially in the studies from the USA [19,20], but attendance was sometimes not influenced by insurance [21]. Self-employed or casual employees reported costs owing to lost income when they took time off work to attend screening appointments [22,23].…”

Section: Environmental Context and Resources (52 Studies)mentioning

confidence: 99%

Barriers to and enablers of diabetic retinopathy screening attendance: a systematic review of published and grey literature

et al. 2018

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Section: Environmental Context and Resources (52 Studies)mentioning

confidence: 99%

Barriers to and enablers of diabetic retinopathy screening attendance: a systematic review of published and grey literature

et al. 2018

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“…Hwang, J. et al in Canada showed that duration of DM longer than 10 years (OR 1.5, 95% CI 1.04-2.25, p=0.03)] was associated with increased eye screening. (59) Similarly Saadine, J.B. et al mentioned that when the DM disease duration was longer (>15 years, OR 1.9, 95%CI 1.4-2.6, p<0.0001) those were highly likely to attend for follow ups. (80)…”

Section: Resultsmentioning

confidence: 98%

“…This was observed mainly in the paid systems. Having an insurance coverage (OR 2.2, 95% CI 1.2-4.3 p=0.02) was associated with the compliance to annual eye examination (85), increased eye screening (OR 3.2, 95% CI 2.2-4.7, p=0.00)(59) and higher chance of undergoing screening (adjusted OR 1.7, 95% CI 1.4-2.2)(75). It is shown that those who have vision loss (blindness) are 100% willing to pay for the services (mean amount willing to pay-No DR - Taiwan dollars - NTD 468.9 ± 327.7 vs Blindness NTD 822.2 ± 192.2, p=0.0005).…”

Section: Resultsmentioning

confidence: 99%

“…(41) Hwang, J. et al in Canada showed that increased eye screening was associated with discussion of DM complications with health professional (OR 2.0, 95% CI 1.3-3.2, p=0.00). (59) Persons having attended a DM education class (OR 1.5, 95% CI 1.2-1.9) were highly likely of having a dilated eye examination. (49)…”

Section: Resultsmentioning

confidence: 99%

“…(68) Hwang, J. et al in Canada showed that increased eye screening was associated with having visual impairment (OR 2.6, 95% CI 1.7-3.9, p=0.00). (59)…”

Section: Resultsmentioning

confidence: 99%

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Systematic Review on Barriers and Facilitators for Access to Diabetic Retinopathy Screening Services

Piyasena

Yip

Gilbert

et al. 2018

Preprint

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ObjectivesThe aim of this systematic review is to identify the barriers/enablers for the people with diabetes (PwDM) in accessing DRS services (DRSS) and challenges/facilitators for the providers.BackgroundDiabetic retinopathy (DR) can lead to visual impairment and blindness if not detected and treated in time. Achievement of an acceptable level of screening coverage is a challenge in any setting. Both patient-related and provider-related factors affect provision of DR screening (DRS) and uptake of services.MethodsWe searched MEDLINE, Embase, CENTRAL in the Cochrane Library from the databases start date to September 2016. We included the studies reported on barriers and enablers to access DRS by PwDM and studies which have assessed barriers or facilitators experienced by the providers in provision of DRSS. We identified and classified the studies that used quantitative or qualitative methods for data collection and analysis in reporting themes of barriers and enablers.Main ResultsWe included 63 studies primarily describing the barriers and enablers. The findings of these studies were based on PwDM from different socio-economic backgrounds and different levels of income settings. Most of the studies were from high income settings (48/63, 76.2%) and cross sectional in design (49/63, 77.8%). From the perspectives of users, lack of knowledge, attitude, awareness and motivation were identified as major barriers to access DRSS. The enablers to access DRSS were fear of blindness, proximity of screening facility, experiences of vision loss and being concerned of eye complications. Providers often mentioned that lack of awareness and knowledge among the PwDM was the main barrier to access. In their perspective lack of skilled human resources, training programs and infrastructure of retinal imaging and cost of services were the main obstacles in provision of screening services.ConclusionKnowing the barriers to access DRS is a pre-requisite in development of a successful screening program. The awareness, knowledge and attitude of the consumers, availability of skilled human resources and infrastructure emerged as the major barriers to access to DRS in any income setting.

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Interventions to increase attendance for diabetic retinopathy screening

Lawrenson

Graham-Rowe

Lorencatto

et al. 2016

Cochrane Database of Systematic Reviews

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This is the published version of the paper.This version of the publication may differ from the final published version. Permanent repository link: T A B L E O F C O N T E N T S A B S T R A C TThis is the protocol for a review and there is no abstract. The objectives are as follows:The primary objective of the review is to assess the effectiveness of intervention components that seek to increase attendance for diabetic retinopathy screening in people with type 1 and type 2 diabetes. Secondary objectives:• To use validated taxonomies of QI intervention strategies and behaviour change techniques (BCTs) to code the description of interventions in the included studies and determine whether interventions that include particular QI strategies or component BCTs are more effective in increasing screening attendance;• To explore heterogeneity in effect size within and between studies to identify potential explanatory factors for variability in effect size;• To explore differential effects in subgroups to provide information on how equity of screening attendance could be improved;• To critically appraise and summarise current evidence on the resource use, costs and cost-effectiveness. There is limited evidence on the economic burden of diabetic retinopathy. One recent estimate for healthcare costs in Sweden was EUR 106,000 per 100,000 population per year based upon a prevalence of diabetes of 4.8% (95% confidence interval 4.7 to 4.9) (Heintz 2010). These costs exclude cost impacts on those with diabetic retinopathy and their families. Although effective treatments are available for sight-threatening diabetic retinopathy in the form of laser photocoagulation (Evans 2014) and more recently the use of anti-vascular endothelial growth factor inhibitors (Virgili 2014), the success of these interventions is dependent on early detection and timely referral for treatment. Diabetic retinopathy screening fulfils the World Health Organization (WHO) criteria for a screening programme (Scanlon 2008): namely, diabetes-associated visual impairment is an important public health problem; potentially sight-threatening retinopathy has a recognisable latent stage; a universally accepted and effective treatment is available; and screening has been shown to be cost-effective in terms of sight years preserved compared with no screening (Jones 2010). Annual or biennial diabetic retinopathy screening is recommended in many countries using a variety of screening modalities including: ophthalmoscopy performed by a number of healthcare professionals (including ophthalmologists, optometrists, diabetic physicians) or using standard retinal photography or digital fundus imaging (American Diabetes Association 2015; Kristinsson 1995; Scanlon 2008). However, relatively few countries have introduced a national population-based diabetic retinopathy screening programme and in most parts of the world screening remains non-systematic. The reference standard for the detection of diabetic retinopathy consists of seven standard 35-degree colour photographic fie...

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Socioeconomic factors associated with visual impairment and ophthalmic care utilization in patients with type II diabetes

Cited by 33 publications

References 40 publications

Barriers to and enablers of diabetic retinopathy screening attendance: a systematic review of published and grey literature

Barriers to and enablers of diabetic retinopathy screening attendance: a systematic review of published and grey literature

Systematic Review on Barriers and Facilitators for Access to Diabetic Retinopathy Screening Services

Interventions to increase attendance for diabetic retinopathy screening

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