Optometry - Journal of the American Optometric Association
Volume 75, Issue 11 , Pages 709-716, November 2004

Patients’ perspectives on noncompliance with Diabetic Retinopathy Standard of Care Guidelines

  • Brian D. Puent, O.D., M.S.

      Affiliations

    • Corresponding Author InformationCorresponding author: Department of Population Health Sciences, University of Wisconsin Medical School, 610 North Walnut Street, 1052 WARF, Madison, Wisconsin 53726-2336.
  • ,
  • Kelly K. Nichols, O.D., M.P.H., Ph.D.

The Ohio State University College of Optometry, Columbus, Ohio

Article Outline

Background

Periodic dilated eye examinations are recommended by the American Optometric Association, American Academy of Ophthalmology, and American Diabetes Association to detect sight-threatening conditions in diabetic patients. However, many patients with diabetes do not receive this recommended eye care and there is limited research to explain why. The objective of this study was to determine reasons some diabetic patients do not receive a dilated eye examination at least every year.

Methods

A chart review identified patients at The Ohio State University College of Optometry who had not been examined for more than a year, but less than two years. A telephone interview was attempted for all subjects.

Results

Of 100 eligible subjects, 43 completed the telephone interview. The reasons patients with diabetes did not return for a recommended dilated eye examination included transfer of care to another eye doctor, limited personal mobility due to poor overall health, last examination at a homeless clinic, self-reported lack of insurance, and self-reported apathy.

Conclusions

Strategies to improve compliance of patients with diabetes should include reaching patients of low socioeconomic status and those institutionalized for poor overall health. Improved compliance may also come by encouraging patients to use medical insurance for eye examinations and using patient recall systems.

Key Words: Diabetes mellitus, diabetic retinopathy, dilated eye examination, patient compliance, surveys, testing

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References 

  1. Optometric Clinical Practice Guideline. Care of the patient with diabetes mellitus. Report No. 3. St. Louis: American Optometric Association, 2002.
  2. Preferred Practice Pattern: Diabetic Retinopathy. American Academy of Ophthalmology, 1998.
  3. Fong DS, Aiello L, Gardner TW, et al. Retinopathy in diabetes. Diabetes Care. 2004;27(Suppl l):S84–S87
  4. U.S. Department of Health and Human Services. Healthy People 2010, 2000.
  5. Diabetes Surveillance System: Statistics. In: Centers for Disease Control and Prevention, 2001.
  6. The State of Health Care Quality Report, 2003. In: National Committee for Quality Assurance, 2003.
  7. Wang F, Javitt JC. Eye care for elderly Americans with diabetes mellitus. Failure to meet current guidelines. Ophthalmology. 1996;103:1744–1750
  8. Schoenfeld ER, Greene JM, Wu SY, et al. Patterns of adherence to diabetes vision care guidelines: baseline findings from the Diabetic Retinopathy Awareness Program. Ophthalmology. 2001;108:563–571
  9. Bennett LW. Effectiveness in meeting recommended standards for annual diabetic eye examinations at a Veterans Health Administration facility. Mil Med. 2002;167(3):242–247
  10. Brechner RJ, Cowie CC, Howie LJ, et al. Ophthalmic examination among adults with diagnosed diabetes mellitus. JAMA. 1993;270:1714–1718
  11. Edlow RC, Markus GR. The state of the profession: 2002. Optometry. 2002;73:55–60
  12. Jorgensen WA, Polivka BJ, Lennie TA. Perceived adherence to prescribed or recommended standards of care among adults with diabetes. Diabetes Educ. 2002;28:989–998
  13. Lawler FH, Viviani N. Patient and physician perspectives regarding treatment of diabetes: compliance with practice guidelines. J Fam Pract. 1997;44:369–373
  14. Stolar MW. Clinical management of the NIDDM patient. Impact of the American Diabetes Association practice guidelines, 1985–1993. Endocrine Fellows Foundation Study Group. Diabetes Care. 1995;18:701–707
  15. Walker EA, Wylie-Rosett J, Shamoon H, et al. Program development to prevent complications of diabetes. Assessment of barriers in an urban clinic. Diabetes Care. 1995;18:1291–1293
  16. Dunn NR, Bough P. Standards of care of diabetic patients in a typical English community. Br J Gen Pract. 1996;46:401–405

PII: S1529-1839(04)70223-7

doi:10.1016/S1529-1839(04)70223-7

Optometry - Journal of the American Optometric Association
Volume 75, Issue 11 , Pages 709-716, November 2004