Non-adherence to eye care in people with diabetes

Ann P. Murchison, Lisa Hark, Laura Pizzi, Yang Dai, Eileen L. Mayro, Philip P. Storey, Benjamin E. Leiby, Julia A. Haller

Research output: Contribution to journalArticle

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Abstract

Objective Evaluate individual factors that impact adherence to eye care follow-up in patients with diabetes. Design and methods A 4-year retrospective chart review was conducted for 1968 patients with diabetes over age 40 from an urban academic center. Data collected included demographics, insurance, visual acuity, smoking status, medications, dates of dilated fundus examinations (DFE), and reported hemoglobin A1C and blood glucose levels. The primary outcome was timely DFE follow-up adherence following the initial eye exam visit. Results Overall, 41.6% of patients adhered to initial follow-up eye care recommendations. Multivariable analysis demonstrated that patients with severe diabetic retinopathy (DR) were more adherent than patients with mild DR (OR 1.86). Other variables associated with increased adherence were visual impairment and reported A1C or blood glucose. Smoking was associated with decreased adherence. Ethnicity and insurance were also significantly associated with adherence. Longitudinal follow-up rates were influenced by additional factors, including ethnicity and neighborhood deprivation index. Conclusions Patients with moderate to severe DR and/ or visual impairment were more likely to adhere to timely DFE follow-up. This could relate to the presence of visual symptoms and/or other systemic manifestations of diabetes. Smokers were less likely to adhere to timely DFE follow-up. One hypothesis is patients who smoke have other symptomatic health problems which patients prioritize over asymptomatic ocular disorders. In order to reduce vision loss from DR, practitioners should be aware that patients with mild and moderate DR, patients with normal vision, and smokers are at greater risk for poor follow-up eye care adherence.

Original languageEnglish (US)
Article numbere000333
JournalBMJ Open Diabetes Research and Care
Volume5
Issue number1
DOIs
StatePublished - Jul 1 2017

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Diabetic Retinopathy
Aftercare
Vision Disorders
Insurance
Blood Glucose
Smoking
Smoke
Visual Acuity
Hemoglobins
Demography
Health

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism

Cite this

Murchison, A. P., Hark, L., Pizzi, L., Dai, Y., Mayro, E. L., Storey, P. P., ... Haller, J. A. (2017). Non-adherence to eye care in people with diabetes. BMJ Open Diabetes Research and Care, 5(1), [e000333]. https://doi.org/10.1136/bmjdrc-2016-000333
Murchison, Ann P. ; Hark, Lisa ; Pizzi, Laura ; Dai, Yang ; Mayro, Eileen L. ; Storey, Philip P. ; Leiby, Benjamin E. ; Haller, Julia A. / Non-adherence to eye care in people with diabetes. In: BMJ Open Diabetes Research and Care. 2017 ; Vol. 5, No. 1.
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Murchison, AP, Hark, L, Pizzi, L, Dai, Y, Mayro, EL, Storey, PP, Leiby, BE & Haller, JA 2017, 'Non-adherence to eye care in people with diabetes', BMJ Open Diabetes Research and Care, vol. 5, no. 1, e000333. https://doi.org/10.1136/bmjdrc-2016-000333

Non-adherence to eye care in people with diabetes. / Murchison, Ann P.; Hark, Lisa; Pizzi, Laura; Dai, Yang; Mayro, Eileen L.; Storey, Philip P.; Leiby, Benjamin E.; Haller, Julia A.

In: BMJ Open Diabetes Research and Care, Vol. 5, No. 1, e000333, 01.07.2017.

Research output: Contribution to journalArticle

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N2 - Objective Evaluate individual factors that impact adherence to eye care follow-up in patients with diabetes. Design and methods A 4-year retrospective chart review was conducted for 1968 patients with diabetes over age 40 from an urban academic center. Data collected included demographics, insurance, visual acuity, smoking status, medications, dates of dilated fundus examinations (DFE), and reported hemoglobin A1C and blood glucose levels. The primary outcome was timely DFE follow-up adherence following the initial eye exam visit. Results Overall, 41.6% of patients adhered to initial follow-up eye care recommendations. Multivariable analysis demonstrated that patients with severe diabetic retinopathy (DR) were more adherent than patients with mild DR (OR 1.86). Other variables associated with increased adherence were visual impairment and reported A1C or blood glucose. Smoking was associated with decreased adherence. Ethnicity and insurance were also significantly associated with adherence. Longitudinal follow-up rates were influenced by additional factors, including ethnicity and neighborhood deprivation index. Conclusions Patients with moderate to severe DR and/ or visual impairment were more likely to adhere to timely DFE follow-up. This could relate to the presence of visual symptoms and/or other systemic manifestations of diabetes. Smokers were less likely to adhere to timely DFE follow-up. One hypothesis is patients who smoke have other symptomatic health problems which patients prioritize over asymptomatic ocular disorders. In order to reduce vision loss from DR, practitioners should be aware that patients with mild and moderate DR, patients with normal vision, and smokers are at greater risk for poor follow-up eye care adherence.

AB - Objective Evaluate individual factors that impact adherence to eye care follow-up in patients with diabetes. Design and methods A 4-year retrospective chart review was conducted for 1968 patients with diabetes over age 40 from an urban academic center. Data collected included demographics, insurance, visual acuity, smoking status, medications, dates of dilated fundus examinations (DFE), and reported hemoglobin A1C and blood glucose levels. The primary outcome was timely DFE follow-up adherence following the initial eye exam visit. Results Overall, 41.6% of patients adhered to initial follow-up eye care recommendations. Multivariable analysis demonstrated that patients with severe diabetic retinopathy (DR) were more adherent than patients with mild DR (OR 1.86). Other variables associated with increased adherence were visual impairment and reported A1C or blood glucose. Smoking was associated with decreased adherence. Ethnicity and insurance were also significantly associated with adherence. Longitudinal follow-up rates were influenced by additional factors, including ethnicity and neighborhood deprivation index. Conclusions Patients with moderate to severe DR and/ or visual impairment were more likely to adhere to timely DFE follow-up. This could relate to the presence of visual symptoms and/or other systemic manifestations of diabetes. Smokers were less likely to adhere to timely DFE follow-up. One hypothesis is patients who smoke have other symptomatic health problems which patients prioritize over asymptomatic ocular disorders. In order to reduce vision loss from DR, practitioners should be aware that patients with mild and moderate DR, patients with normal vision, and smokers are at greater risk for poor follow-up eye care adherence.

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