Evaluation of diabetic retinopathy screening rates among patients with diabetes: a clinical audit
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20252483Keywords:
Diabetes, Diabetic retinopathy, Screening, Fundus examinationAbstract
Background: Diabetic retinopathy (DR) is the most common microvascular ocular complication of diabetes. The sight threatening DR which can be prevented by timely screening, thus highlighting the importance of DR screening.
Methods: A prospective observational study was conducted to evaluate the percentage of patients with diabetes undergoing screening for diabetic retinopathy. The study was done in 2 cycles with time for remedial measures in between the cycles. All the patients who presented to the OPD with known diabetes on treatment, history of pre-existing diabetes, history of gestational diabetes, RBS more than 200 mg/dl and HbA1c more than 6.5% were included in the study.
Results: In the first cycle, 78.2% underwent dilated fundus examination. The main reasons for not doing the fundus examination were the patient was within the follow-up period, the patient refused due to various reasons or that the doctor didn’t perform. In the second cycle, the percentage of patients undergone dilated fundus examination rose up to 88.9%.
Conclusions: There was a significant lag in the number of patients who undergo dilated fundus examination for dilated retinopathy screening. With the help of educating the healthcare personnel and stressing on the counselling of the patients, the number of screening cases can be improved. But there is a need for continuous efforts for the gap to be fully covered.
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References
Tripathy JP, Thakur JS, Jeet G, Chawla S, Jain S, Pal A, et al. Prevalence and risk factors of diabetes in a large community-based study in North India: Results from a STEPS survey in Punjab, India. Diabetol Metab Syndr. 2017;9:8. DOI: https://doi.org/10.1186/s13098-017-0207-3
Khan J, Shaw S. Risk of cataract and glaucoma among older persons with diabetes in India: a cross-sectional study based on LASI, Wave-1. Sci Rep 2023;13(1):11973. DOI: https://doi.org/10.1038/s41598-023-38229-z
Brar AS, Sahoo J, Behera UC, Jonas JB, Sivaprasad S, Das T. Prevalence of diabetic retinopathy in urban and rural India: a systematic review and meta-analysis. Indian J Ophthalmol. 2022;70(6):1945-55. DOI: https://doi.org/10.4103/ijo.IJO_2206_21
Anjana RM, Deepa M, Pradeepa R, Mahanta J, Narain K, Das HK, et al. Prevalence of diabetes and prediabetes in 15 states of India: results from the ICMR–INDIAB population-based cross-sectional study. Lancet Diabetes Endocrinol. 2017;5:585-96. DOI: https://doi.org/10.1016/S2213-8587(17)30174-2
Singh A, Tripathi A, Kharya P, Agarwal R. Awareness of diabetic retinopathy among diabetes mellitus patients visiting a hospital of North India. J Family Med Prim Care. 2022;11:1292-8. DOI: https://doi.org/10.4103/jfmpc.jfmpc_977_21
American Diabetes Association. Diabetic retinopathy. Diabetes Care. 2000;23(Suppl 1):S73-6.
Raman R, Ramasamy K, Rajalakshmi R, Sivaprasad S, Natarajan S. Diabetic retinopathy screening guidelines in India: All India Ophthalmological Society diabetic retinopathy task force and Vitreoretinal Society of India Consensus Statement. Indian J Ophthalmol. 2021;69:678-88. DOI: https://doi.org/10.4103/ijo.IJO_667_20
Scanlon PH. The English National Screening Programme for diabetic retinopathy 2003-2016. Acta Diabetol. 2017;54(6):515-25.
Jani PD, Forbes L, Choudhury A, Preisser JS, Viera AJ, Garg S. Evaluation of diabetic retinal screening and factors for ophthalmology referral in a telemedicine network. JAMA Ophthalmol. 2017;135(7):706-14. DOI: https://doi.org/10.1001/jamaophthalmol.2017.1150
Al-Alawi A, Al-Hassan A, Chauhan D, Al-Futais M, Khandekar R. Knowledge, attitude, and perception of barriers for eye care among diabetic persons registered at employee health department of a tertiary eye hospital of central Saudi Arabia. Middle East Afr J Ophthalmol. 2016;23(1):71-4. DOI: https://doi.org/10.4103/0974-9233.164629
Hipwell AE, Sturt J, Lindenmeyer A, Stratton I, Gadsby R, O’Hare P, et al. Attitudes, access and anguish: a qualitative interview study of staff and patients' experiences of diabetic retinopathy screening. BMJ Open. 2014;4(12):e005498. DOI: https://doi.org/10.1136/bmjopen-2014-005498
Eborall H, Davies R, Kinmonth AL, Griffin S, Lawton J. Patients’ experiences of screening for type 2 diabetes: prospective qualitative study embedded in the ADDITION (Cambridge) randomised controlled trial. BMJ. 2007;335(7618):490. DOI: https://doi.org/10.1136/bmj.39308.392176.BE
Zhang X, Norris SL, Saadine J, Chowdhury FM, Horsley T, Kanjilal S, et al. Effectiveness of interventions to promote screening for diabetic retinopathy. Am J Prev Med. 2007;33(4):318-35. DOI: https://doi.org/10.1016/j.amepre.2007.05.002
Fabius RJ, Krakovitz J. Implementing guidelines for eye care of diabetic patients: results from an HMO intervention study. Am J Managed Care. 1996;2:365-9.
Chicoye L, Roethel CR, Hatch MH, Wesolowski W. Diabetes care management: a managed care approach. World Med J. 1998;97:32-4.
Maliszewski M, Dennis C, DeCoste KC. Prevention, detection, and treatment of diabetic eye disease: an overview and demonstration project. Diabetes Educ. 1988;14:416-20. DOI: https://doi.org/10.1177/014572178801400510
Schectman JM, Schorling JB, Nadkarni MM, Lyman JA, Siadaty MS, Voss JD. The effect of physician feedback and an action checklist on diabetes care measures. Am J Med Qual. 2004;19:207-13. DOI: https://doi.org/10.1177/106286060401900505
Glasgow RE, Nutting PA, King DK, Nelson CC, Cutter G, Gaglio B, et al. A practical randomized trial to improve diabetes care. J Gen Intern Med 2004;19:1167-74. DOI: https://doi.org/10.1111/j.1525-1497.2004.30425.x
McCulloch DK, Price MJ, Hindmarsh M, Wagner EH. A population-based approach to diabetes management in a primary care setting: early results and lessons learned. Eff Clin Pract. 1998;1:12-22.
Ramasamy K, Mishra C, Kannan NB, Namperumalsamy P, Sen S. Telemedicine in diabetic retinopathy screening in India. Indian J Ophthalmol. 2021;69(11):2977-86. DOI: https://doi.org/10.4103/ijo.IJO_1442_21
Scanlon PH. The English National Screening Programme for diabetic retinopathy 2003-2016. Acta Diabetol. 2017;54:515-25. DOI: https://doi.org/10.1007/s00592-017-0974-1
Nguyen HV, Tan GSW, Tapp RJ, Mital S, Ting DSW, Wong HT, et al. Cost-effectiveness of a national telemedicine diabetic retinopathy screening program in Singapore. Ophthalmology. 2016;123:2571-80. DOI: https://doi.org/10.1016/j.ophtha.2016.08.021