Why Do Diabetic Patients Skip Retinopathy Screenings? UK Study Reveals

A recent study conducted by a research team from England has identified several key factors that prevent patients with diabetes from attending their annual diabetic eye screenings. These include mental health issues, lack of awareness about diabetic eye screening, and difficulties related to transport. The research, led by Dr. Upamanyu Leo Chanda from the Emergency Department at New Cross Hospital, Royal Wolverhampton Trust, sheds light on why many diabetes patients fail to follow guidelines set by the National Institute for Health and Care Excellence (NICE), which recommends annual eye screening for individuals aged 12 and older.

The Importance of Diabetic Retinopathy Screenings

Diabetic retinopathy, a sight-threatening complication of diabetes, requires regular monitoring to prevent vision loss. NICE’s guidelines call for annual eye screenings for diabetic patients, but many do not adhere to these guidelines. Dr. Chanda and his team aimed to investigate the reasons behind this non-compliance by conducting a retrospective clinical audit of about 9,000 patients.

Study Methods and Findings

To explore why patients were missing their screenings, the researchers used the SystmOne patient database to identify individuals who had missed their eye exams in the past 15 to 36 months. Patients who had missed screenings in the 36-month group were classified as non-attenders.

The researchers found that a survey of every third patient who missed a screening in the last 15 months revealed key barriers to attendance. “Mental health issues, lack of diabetic eye screening (DES) awareness, and transport difficulties were primary reasons for non-attendance,” the researchers explained. Despite these challenges, the eye screening uptake rates were relatively high. The rates were 77.2% for the 15-month cohort and 83.6% for the 36-month cohort, both exceeding the NHS target of 75%.

Proposed Solutions to Improve Retinopathy Screening Attendance

The researchers identified several key factors contributing to the low attendance at screenings and proposed several interventions to improve patient adherence. These included telephone prompts for patients with mental health concerns, text message reminders before appointments, and online educational tools aimed at increasing awareness about diabetic retinopathy and the importance of regular eye exams.

Among the reasons identified for non-attendance, mental health issues and lack of knowledge about diabetic retinopathy were the most common. The study suggests that targeted interventions could address these issues and help improve attendance rates. “Telephone prompts for patients with known mental health conditions, text message reminders, and online educational portals should help increase the number of patients who attend their annual screenings,” the team suggested.

The Need for Continued Awareness and Support About Retinopathy Screenings

The researchers emphasized the importance of ongoing efforts to raise awareness and support patients in attending regular screenings. “Future re-audits following the implementation of the proposed interventions could help evaluate the impact of these strategies and provide further insights into optimising diabetic retinopathy screening in primary care practices,” they noted.

Improving Early Detection and Patient Outcomes

While the screening rates in this study exceeded the national guidelines, the researchers highlighted the importance of addressing specific barriers to increase screening rates. By improving attendance, they believe more cases of early-stage diabetic retinopathy could be detected, leading to better patient outcomes. “Despite standards exceeding the national guidelines, this audit demonstrates the importance of addressing specific barriers to enhance screening rates, potentially increasing the detection of early retinopathy and improving patient outcomes,” said Dr. Chanda and his colleagues.