Low utility of diabetic eye care services and perceived barriers to optimal diabetic retinopathy management in Indonesian adults with vision-threatening diabetic retinopathy

2020 ◽  
pp. 108540
Author(s):  
Muhammad B. Sasongko ◽  
Sarah R. Indrayanti ◽  
Firman S. Wardhana ◽  
Idhayu A. Widhasari ◽  
Felicia Widyaputri ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Perceived Barriers ◽  
Eye Care ◽  
Care Services

scholarly journals Eye care delivery models to improve access to eye care for Indigenous peoples in high-income countries: a scoping review

2021 ◽  
Vol 6 (3) ◽  
pp. e004484
Author(s):  
Helen Burn ◽  
Lisa Hamm ◽  
Joanna Black ◽  
Anthea Burnett ◽  
Matire Harwood ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Service Delivery ◽  
Indigenous Peoples ◽  
Indigenous Communities ◽  
High Income ◽  
Eye Care ◽  
Service Delivery Models ◽  
Care Services ◽  
Delivery Models ◽  
Improve Access

PurposeGlobally, there are ~370 million Indigenous peoples. Indigenous peoples typically experience worse health compared with non-Indigenous people, including higher rates of avoidable vision impairment. Much of this gap in eye health can be attributed to barriers that impede access to eye care services. We conducted a scoping review to identify and summarise service delivery models designed to improve access to eye care for Indigenous peoples in high-income countries.MethodsSearches were conducted on MEDLINE, Embase and Global Health in January 2019 and updated in July 2020. All study designs were eligible if they described a model of eye care service delivery aimed at populations with over 50% Indigenous peoples. Two reviewers independently screened titles, abstracts and full-text articles and completed data charting. We extracted data on publication details, study context, service delivery interventions, outcomes and evaluations, engagement with Indigenous peoples and access dimensions targeted. We summarised findings descriptively following thematic analysis.ResultsWe screened 2604 abstracts and 67 studies fulfilled our eligibility criteria. Studies were focused on Indigenous peoples in Australia (n=45), USA (n=11), Canada (n=7), New Zealand (n=2), Taiwan (n=1) and Greenland (n=1). The main disease focus was diabetic retinopathy (n=30, 45%), followed by ‘all eye care’ (n=16, 24%). Most studies focused on targeted interventions to increase availability of services. Fewer than one-third of studies reported involving Indigenous communities when designing the service. 41 studies reflected on whether the model improved access, but none undertook rigorous evaluation or quantitative assessment.ConclusionsThe geographical and clinical scope of service delivery models to improve access to eye care for Indigenous peoples in high-income countries is narrow, with most studies focused on Australia and services for diabetic retinopathy. More and better engagement with Indigenous communities is required to design and implement accessible eye care services.

scholarly journals Cukorbetegség és retinopathia diabetica regionális egyenlőtlenségei Magyarországon az 50 éves és idősebb korú lakosság körében

2017 ◽  
Vol 158 (10) ◽  
pp. 362-367 ◽  
Author(s):  
Gábor Tóth ◽  
Dorottya Szabó ◽  
Gábor László Sándor ◽  
Anita Pék ◽  
Irén Szalai ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Primary Care ◽  
Diabetic Retinopathy ◽  
Screening Program ◽  
Rapid Assessment ◽  
Fundus Examination ◽  
Eye Care ◽  
Care Services ◽  
Eye Screening ◽  
Retinopathia Diabetica

Abstract: Introduction: Diabetes mellitus (DM) is one of the main causes of blindness among persons aged 50 years and older. Aim: The purpose of our survey was to estimate the prevalence of DM and diabetic retinopathy (DR), as well as to assess the coverage of diabetic eye care services in different regions of Hungary. Method: In 105 clusters, 3675 people aged 50 years and older were included in the survey. The standardized rapid assessment of avoidable blindness (RAAB) with the diabetic retinopathy module (DRM) was used to examine the participants. Thereafter, differences between West-, Middle- and East-Hungary were analysed. Results: Prevalence of DM was higher in East-Hungary (20.9%), than in West- (19.5%) and in Middle-Hungary (19.5%). Prevalence od DR was higher in West-Hungary (24.1%), than in Middle- (17.8%) and in East-Hungary (19.6%). Proportion of participants who never had a fundus examination for DR was the lowest in Middle-Hungary (19.1%). Conclusions: Primary care should be strenghten mainly in country settlements or telemedical eye screening program should be started to decrease the prevalence of diabetic eye complications. Orv. Hetil., 2017, 158(10), 362–367.

scholarly journals Generating evidence for planning eye care service delivery in an urban underprivileged population setting in Pune, Western India

2019 ◽  
Vol 4 (1) ◽  
pp. e000202
Author(s):  
Sucheta Kulkarni ◽  
Shridevi Kondalkar ◽  
Islay Mactaggart ◽  
B R Shamanna ◽  
Azher Lodhi ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Service Providers ◽  
Care Service ◽  
Rapid Assessment ◽  
Evidence Base ◽  
Posterior Segment ◽  
Western India ◽  
Eye Care ◽  
Care Services ◽  
Estimate Prevalence

PurposeTo estimate prevalence of blindness, diabetic retinopathy and causes of blindness through rapid assessment of avoidable blindness (RAAB) survey in Pune, India to develop an evidence base for planning urban eye care services.Methods‘Rapid assessment of avoidable blindness and diabetic retinopathy’ methodology was used. Compact segment sampling was used in each of the 60 selected electoral wards identified through cluster selection module of the RAAB software using probability proportionate to size method. Persons >50 years of age were enumerated from selected segments to achieve cumulative target of 60/day by two teams. Participants underwent presenting and pinhole visual acuity (VA) testing in each eye. A torch light examination and direct ophthalmoscopy established cause of visual impairment/blindness if present. Data were entered into and analysed using RAAB software.ResultsThe response rate was 89.5% (3221/3600), and 55.3% were women. Results of only RAAB module are presented in this paper. Age-standardised and sex-standardised prevalence of blindness was 1.3% (95% CI 0.9 to 1.8). Cataract was the most common cause of blindness (45.7%) followed by overall posterior segment disorders (39.1%). Cataract surgical outcome was good (VA>6/18) or very good (VA>6/12) in 805/1190 (67.6%) cases. Cataract surgical coverage was 96.7%. ‘Need not felt’ (36.6%) and ‘cost’ (31.7%) were the most common barriers for cataract surgery.ConclusionPrevalence of blindness is showing declining trend in urban India. Cataract remains a major cause of blindness followed by posterior segment disorders. Social marketing, and referral linkages between community and service providers were planned after this survey.

Assessment of awareness of diabetic retinopathy and utilization of eye care services among Turkish diabetic patients

2013 ◽  
Vol 7 (4) ◽  
pp. 297-302 ◽  
Author(s):  
Ebru N. Çetin ◽  
Mehmet Zencir ◽  
Semin Fenkçi ◽  
Fulya Akın ◽  
Cem Yıldırım
Keyword(s):  
Diabetic Retinopathy ◽  
Diabetic Patients ◽  
Eye Care ◽  
Care Services

scholarly journals Population-based cross-sectional prevalence survey of diabetes and diabetic retinopathy in Sohag—Egypt, 2019

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e047757
Author(s):  
Heba AlSawahli ◽  
Caleb D Mpyet ◽  
Gamal Ezzelarab ◽  
Ibrahim Hassanin ◽  
Mohammad Shalaby ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Rapid Assessment ◽  
Good Control ◽  
Population Based ◽  
Secondary Outcome ◽  
Public Health Approach ◽  
Eye Care ◽  
Cross Sectional Survey ◽  
Prevalence Survey ◽  
Cross Sectional

ObjectivesTo determine the prevalence of diabetes mellitus (DM), prevalence of diabetic retinopathy (DR) and sight-threatening conditions among persons with DM aged 50 years and older in Sohag governorate in Upper Egypt.DesignPopulation-based, cross-sectional survey using the standardised Rapid Assessment of Avoidable Blindness with the addition of the Diabetic Retinopathy module methodology.SettingsSohag governorate in Egypt where 68 clusters were selected using probability proportional to population size. Households were selected using the compact segment technique.Participants4078 people aged 50 years and older in 68 clusters were enrolled, of which 4033 participants had their random blood sugar checked and 843 examined for features of DR.Primary and secondary outcomesThe prevalence of DM and DR; secondary outcome was the coverage with diabetic eye care.ResultsThe prevalence of DM was 20.9% (95% CI 19.3% to 22.5%). The prevalence in females (23.8%; 95% CI 21.4% to 26.3%) was significantly higher than in males (18.9%; 95% CI 17.1% to 20.7%) (p=0.0001). Only 38.8% of persons diagnosed with diabetes had good control of DM. The prevalence of DR in the sample was 17.9% (95% CI 14.7% to 21.1%). The prevalence in females was higher (18.9%; 95% CI 14.0% to 23.8%) than in males (17.1%; 95% CI 13.0% to 21.2%). Up to 85.3% of study participants have never had eye examination. Sight-threatening DR (R4 and/or M2) was detected in 5.2% (95% CI 3.4% to 7.0%) with only 2.3% having had laser treatment.ConclusionThe prevalence of uncontrolled DM in Sohag governorate in Egypt is higher than the national prevalence. There is a high prevalence of sight-threatening retinopathy and/or maculopathy with few people having access to diabetic eye care. A public health approach is needed for health promotion, early detection and management of DR.

scholarly journals Situational analysis of diabetic retinopathy treatment Services in Ghana

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Agatha Mensah-Debrah ◽  
Kwesi Nyan Amissah Arthur ◽  
David Ben Kumah ◽  
Kwadwo Owusu Akuffo ◽  
Isaiah Osei Duah ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Vitreoretinal Surgery ◽  
Health Facilities ◽  
Service Utilisation ◽  
Eye Care ◽  
Treatment Service ◽  
Treatment Services ◽  
Disadvantaged Population ◽  
Anti Vegf ◽  
Geographical Regions

Abstract Background Although the equitable distribution of diabetic retinopathy (DR) services across Ghana remains paramount, there is currently a poor understanding of nationwide DR treatment services. This study aims to conduct a situation analysis of DR treatment services in Ghana and provide evidence on the breadth, coverage, workload, and gaps in service delivery for DR treatment. Methods A cross-sectional study was designed to identify health facilities which treat DR in Ghana from June 2018 to August 2018. Data were obtained from the facilities using a semi-structured questionnaire which included questions identifying human resources involved in DR treatment, location of health facilities with laser, vitreoretinal surgery and Anti–vascular endothelial growth factor therapy (Anti-VEGF) for DR treatment, service utilisation and workload at these facilities, and the average price of DR treatment in these facilities. Results Fourteen facilities offer DR treatment in Ghana; four in the public sector, seven in the private sector and three in the Christian Health Association of Ghana (CHAG) centres. There was a huge disparity in the distribution of facilities offering DR services, the eye care cadre, workload, and DR treatment service (retinal laser, Anti-VEGF, and vitreoretinal surgery). The retinal laser treatment price was independent of all variables (facility type, settings, regions, and National Health Insurance Scheme coverage). However, settings (p = 0.028) and geographical regions (p = 0.010) were significantly associated with anti-VEGF treatment price per eye. Conclusion Our results suggest a disproportionate distribution of DR services in Ghana. Hence, there should be a strategic development and implementation of an eye care plan to ensure the widespread provision of DR services to the disadvantaged population as we aim towards a disadvantaged population as we aim towards a universal health coverage.

Clinical staff impressions on implementation of a teleophthalmology program to improve diabetic retinopathy surveillance informed by implementation science frameworks (Preprint)

2021 ◽  
Author(s):  
Rajeev S. Ramchandran ◽  
Reza Yousefi-Nooraie ◽  
Porooshat Dadgostar ◽  
Sule Yilmaz ◽  
Jesica Basant ◽  
...  
Keyword(s):  
Primary Care ◽  
Diabetic Retinopathy ◽  
Care Coordination ◽  
Low Income ◽  
Safety Net ◽  
The United States ◽  
Eye Care ◽  
Continuous Training ◽  
Effective Care ◽  
Store And Forward

BACKGROUND Store and forward camera based evaluation or teleophthalmology is considered an effective way to identify diabetic retinopathy, the leading cause of blindness in the United States, but uptake has been slow. OBJECTIVE Understanding the barriers and facilitators of implementing teleophthalmology programs from those actively adopting, running, and sustaining such programs is important for widespread adoption. METHODS This qualitative study in three urban low-income, largely minority-serving safety-net primary care clinics in Rochester, NY, USA interviewed nurses and doctors on implementing a teleophthalmology program using questions informed by Practical, Robust Implementation and Sustainability Model (PRISM) and Consolidated Framework for Implementation Research (CFIR) frameworks. RESULTS Primary care nurses operationalizing the program in their clinics saw increased work burden and lack of self-efficacy as barriers. Continuous training on the teleophthalmology process for nurses, doctors, and administrative staff through in-service and peer-training by champions/super-users were identified by interviewees as needs. Facilitators included the perceived convenience for the patient and a perceived educational advantage to the program as it gave an opportunity for providers to discuss the importance of eye care with patients. Concerns in making and tracking referrals to ophthalmology due to challenges related to care coordination were highlighted. Financial aspects of the program (e.g. patient coverage and care provider reimbursement) were unclear to many staff, influencing adoption and sustainability. CONCLUSIONS Streamlining of processes and workflows, training and assigning adequate staff, effective care coordination between primary care and eye care to improve follow-ups, and ensuring financial viability can all help streamline the adoption of teleophthalmology.

scholarly journals Public Awareness regarding the Differences between Ophthalmologists and Optometrists among Saudi Adults Living in Riyadh: A Quantitative Study

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Mohammed Hamad Aldebasi ◽  
Nasser Abdalazez Alsobaie ◽  
Abdulrahman Yousef Aldayel ◽  
Khalid Mousa Alwusaidi ◽  
Tariq Alasbali
Keyword(s):  
Saudi Arabia ◽  
Public Awareness ◽  
Multivariate Logistic Regression Analysis ◽  
Public Knowledge ◽  
Multivariate Logistic Regression ◽  
Eye Care ◽  
Online Questionnaire ◽  
Awareness Campaign ◽  
Care Services ◽  
Population Education

Awareness of the patients to the differences between ophthalmologists and optometrists has been recognized as an important factor influencing patient utilization of available eye care services. This study aimed at assessing the public’s knowledge of the differences between ophthalmologists and optometrists among the residents of Riyadh, Saudi Arabia. An online questionnaire was administered to adults in Riyadh, Saudi Arabia, from January to February in 2018. The number of the respondents was 1579. Results show that 50% (n=789) of the participants had fair knowledge of the differences between ophthalmologists and optometrists, while 32% (n=505) had poor knowledge. After multivariate logistic regression analysis, there was a significant association between satisfactory knowledge and visiting an optometrist (odds ratio (OR): 0.75, 95% CI: 0.57–0.98), age older than 26 (OR: 1.73, 95% CI: 1.17–1.19), higher level of education (OR: 1.92, 95% CI: 1.54–2.4), and wearing spectacles (OR: 0.57, 95% CI: 0.45–0.73). Given the low level of public knowledge regarding the differences in the duties between ophthalmologist and optometrists among a Saudi population, there is great potential for general population education through awareness campaign and social media regarding eye care provider’s duties and practices.

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