scholarly journals Perceived barriers and enablers to the provision of diabetic retinopathy screening for young adults: a cross-sectional survey of healthcare professionals working in the UK National Diabetic Eye Screening Programme

2021 ◽  
Vol 9 (2) ◽  
pp. e002436
Author(s):  
Louise Prothero ◽  
Fabianna Lorencatto ◽  
Martin Cartwright ◽  
Jennifer M Burr ◽  
Philip Gardner ◽  
...  
Keyword(s):  
Young Adults ◽  
Screening Programme ◽  
Perceived Barriers ◽  
Self Management ◽  
Screening Uptake ◽  
Diabetic Retinopathy Screening ◽  
Eye Screening ◽  
Diabetic Eye Screening ◽  
The Uk ◽  
Retinopathy Screening

IntroductionDiabetic retinopathy screening (DRS) attendance in young adults is consistently below recommended levels. The aim of this study was to conduct a survey of screening providers in the UK Diabetic Eye Screening Programme (DESP) to identify perceived barriers and enablers to DRS attendance in young adults and elicit views on the effectiveness of strategies to improve screening uptake in this population.Research design and methodsMembers of the British Association of Retinal Screening (n=580) were invited to complete an anonymous online survey in July 2020 assessing agreement with 37 belief statements, informed by the Theoretical Domains Framework (TDF) of behavior change, describing potential barrier/enablers to delivering DRS for young adults and further survey items exploring effectiveness of strategies to improve uptake of DRS.ResultsIn total, 140 (24%) responses were received mostly from screener/graders (67.1%). There was a high level of agreement that the DESP had a role in improving attendance in young adults (96.4%) and that more could be done to improve attendance (90.0%). The most commonly reported barriers related to TDF domains Social influences and Environmental context and resources including lack of integration of DRS with other processes of diabetes care, which limited the ability to discuss diabetes self-management. Other barriers included access to screening services and difficulties with scheduling appointments. Less than half (46.4%) of respondents reported having a dedicated strategy to improve screening uptake in young adults. Strategies perceived to be effective included: screening within the community; prompts/reminders and integrating eye screening with other diabetes services.ConclusionsScreening providers were concerned about screening uptake in young adults, although many programs lacked a dedicated strategy to improve attendance. Problems associated with a lack of integration between DRS with other diabetes care processes were identified as a major barrier to providing holistic care to young adults and supporting diabetes self-management.

scholarly journals Can Commercially Available Handheld Retinal Cameras Effectively Screen Diabetic Retinopathy?

2016 ◽  
Vol 11 (1) ◽  
pp. 135-137 ◽  
Author(s):  
Jorge Cuadros ◽  
George Bresnick
Keyword(s):  
Clinical Trials ◽  
Diabetic Retinopathy ◽  
Screening Programme ◽  
Low Cost ◽  
Clinical Results ◽  
Diabetic Retinopathy Screening ◽  
The United Kingdom ◽  
Eye Screening ◽  
Diabetic Eye Screening ◽  
Retinopathy Screening

Organizations that care for people with diabetes have increasingly adopted telemedicine-based diabetic retinopathy screening (TMDRS) as a way to increase adherence to recommended retinal exams. Recently, handheld retinal cameras have emerged as a low-cost, lightweight alternative to traditional bulky tabletop retinal cameras. Few published clinical trials have been performed on handheld retinal cameras. Peer-reviewed articles about commercially available handheld retinal cameras have concluded that they are a usable alternative for TMDRS, however, the clinical results presented in these articles do not meet criteria published by the United Kingdom Diabetic Eye Screening Programme and the American Academy of Ophthalmology. The future will likely remedy the shortcomings of currently available handheld retinal cameras, and will create more opportunities for preventing diabetic blindness.

scholarly journals Diagnostic accuracy of diabetic retinopathy grading by an artificial intelligence-enabled algorithm compared with a human standard for wide-field true-colour confocal scanning and standard digital retinal images

2020 ◽  
pp. bjophthalmol-2019-315394
Author(s):  
Abraham Olvera-Barrios ◽  
Tjebo FC Heeren ◽  
Konstantinos Balaskas ◽  
Ryan Chambers ◽  
Louis Bolter ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Screening Programme ◽  
Proliferative Retinopathy ◽  
Retinal Images ◽  
Wide Field ◽  
Diabetic Retinopathy Screening ◽  
Eye Screening ◽  
Confocal Scanning ◽  
Diabetic Eye Screening ◽  
Retinopathy Screening

BackgroundPhotographic diabetic retinopathy screening requires labour-intensive grading of retinal images by humans. Automated retinal image analysis software (ARIAS) could provide an alternative to human grading. We compare the performance of an ARIAS using true-colour, wide-field confocal scanning images and standard fundus images in the English National Diabetic Eye Screening Programme (NDESP) against human grading.MethodsCross-sectional study with consecutive recruitment of patients attending annual diabetic eye screening. Imaging with mydriasis was performed (two-field protocol) with the EIDON platform (CenterVue, Padua, Italy) and standard NDESP cameras. Human grading was carried out according to NDESP protocol. Images were processed by EyeArt V.2.1.0 (Eyenuk Inc, Woodland Hills, California). The reference standard for analysis was the human grade of standard NDESP images.ResultsWe included 1257 patients. Sensitivity estimates for retinopathy grades were: EIDON images; 92.27% (95% CI: 88.43% to 94.69%) for any retinopathy, 99% (95% CI: 95.35% to 100%) for vision-threatening retinopathy and 100% (95% CI: 61% to 100%) for proliferative retinopathy. For NDESP images: 92.26% (95% CI: 88.37% to 94.69%) for any retinopathy, 100% (95% CI: 99.53% to 100%) for vision-threatening retinopathy and 100% (95% CI: 61% to 100%) for proliferative retinopathy. One case of vision-threatening retinopathy (R1M1) was missed by the EyeArt when analysing the EIDON images, but identified by the human graders. The EyeArt identified all cases of vision-threatening retinopathy in the standard images.ConclusionEyeArt identified diabetic retinopathy in EIDON images with similar sensitivity to standard images in a large-scale screening programme, exceeding the sensitivity threshold recommended for a screening test. Further work to optimise the identification of ‘no retinopathy’ and to understand the differential lesion detection in the two imaging systems would enhance the use of these two innovative technologies in a diabetic retinopathy screening setting.

scholarly journals Implementation for Sustained Impact in Teleophthalmology (I-SITE): applying the NIATx Model for tailored implementation of diabetic retinopathy screening in primary care

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Alejandra Torres Diaz ◽  
Loren J. Lock ◽  
Todd D. Molfenter ◽  
Jane E. Mahoney ◽  
Deanne Boss ◽  
...  
Keyword(s):  
Primary Care ◽  
Implementation Strategies ◽  
Local Context ◽  
Primary Care Clinics ◽  
Diabetic Retinopathy Screening ◽  
Eye Screening ◽  
Implementation Program ◽  
The Us ◽  
Diabetic Eye Screening ◽  
Retinopathy Screening

Abstract Background Teleophthalmology provides evidence-based, telehealth diabetic retinopathy screening that is underused even when readily available in primary care clinics. There is an urgent need to increase teleophthalmology use in the US primary care clinics. In this study, we describe the development of a tailored teleophthalmology implementation program and report outcomes related to primary care provider (PCP) adoption. Methods We applied the 5 principles and 10 steps of the NIATx healthcare process improvement model to develop and test I-SITE (Implementation for Sustained Impact in Teleophthalmology) in a rural, the US multi-payer health system. This implementation program allows patients and clinical stakeholders to systematically tailor teleophthalmology implementation to their local context. We aligned I-SITE components and implementation strategies to an updated ERIC (Expert Recommendations for Implementing Change) framework. We compared teleophthalmology adoption between PCPs who did or did not participate in various components of I-SITE. We surveyed PCPs and clinical staff to identify the strategies they believed to have the highest impact on teleophthalmology use. Results To test I-SITE, we initiated a year-long series of 14 meetings with clinical stakeholders (n=22) and met quarterly with patient stakeholders (n=9) in 2017. Clinical and patient stakeholder groups had 90.9% and 88.9% participant retention at 1 year, respectively. The increase in teleophthalmology use was greater among PCPs participating in the I-SITE implementation team than among other PCPs (p < 0.006). The proportion of all PCPs who used the implementation strategy of electing diabetic eye screening for their annual performance-based financial incentive increased from 0% (n=0) at baseline to 56% (n=14) following I-SITE implementation (p = 0.004). PCPs and clinical staff reported the following implementation strategies as having the highest impact on teleophthalmology use: reminders to ask patients about diabetic eye screening during clinic visits, improving electronic health record (EHR) documentation, and patient outreach. Conclusions We applied the NIATx Model to develop and test a teleophthalmology implementation program for tailored integration into primary care clinics. The NIATx Model provides a systematic approach to engaging key stakeholders for tailoring implementation of evidence-based telehealth interventions into their local context.

scholarly journals Diabetic Retinopathy Screening Programme: Attendance, Barriers and Enablers amongst Young People with Diabetes Mellitus Aged 12–26 Years

2021 ◽  
Vol 1 (3) ◽  
pp. 154-162
Author(s):  
Laura N. Cushley ◽  
Katie Curran ◽  
Nicola B. Quinn ◽  
Aaron Bell ◽  
Alyson Muldrew ◽  
...  
Keyword(s):  
Young People ◽  
Screening Programme ◽  
Diabetes Duration ◽  
Diabetes Clinic ◽  
Diabetic Retinopathy Screening ◽  
Barriers And Enablers ◽  
Eye Screening ◽  
One Stop ◽  
Diabetic Eye Screening ◽  
The Impact

The study aim is to investigate characteristics, barriers and enablers for attendance at the Diabetic Eye Screening Programme Northern Ireland (DESPNI) among people with diabetes aged 12–26 years. A mixed-methods approach with retrospective analysis and prospective, questionnaire-based data collection was completed. Data were analysed using ordinal logistic regression. A questionnaire collected information on barriers and enablers to attending DESPNI. Age, diabetes duration, attendance at diabetes clinic and lower HbA1c values were significantly associated with better attendance. Those aged 12–15 were more likely to attend screening than 16–26 years, odds ratio (OR) 4.01. Subjects diagnosed less than 5 years were more likely to attend than those with longer diabetes duration (OR = 2.52, p =< 0.001). Subjects who attended diabetes clinics were more likely to attend screening (OR = 1.89, p =< 0.001) and have a lower HbA1c (OR = 1.46, p =< 0.001). Questionnaires revealed major barriers to attendance which included inconvenient appointment times, lack of access and poor communication. While many subjects were aware of the impact of diabetes on the eye, many had little understanding of screening. This study provides pivotal information on potential barriers and enablers for young people attending eye screening. We suggest modest changes such as convenient appointment times, clearer communication and one-stop clinics could improve attendance.

Digital Ophthalmology in the UK – Diabetic Retinopathy Screening and Virtual Glaucoma Clinics in the National Health Service

2020 ◽  
Vol 237 (12) ◽  
pp. 1400-1408
Author(s):  
Heinrich Heimann ◽  
Deborah Broadbent ◽  
Robert Cheeseman
Keyword(s):  
Diabetic Retinopathy ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Daily Practice ◽  
Diabetic Retinopathy Screening ◽  
Technological Advances ◽  
Imaging Results ◽  
The Uk ◽  
Retinopathy Screening

AbstractThe customary doctor and patient interactions are currently undergoing significant changes through technological advances in imaging and data processing and the need for reducing person-to person contacts during the COVID-19 crisis. There is a trend away from face-to-face examinations to virtual assessments and decision making. Ophthalmology is particularly amenable to such changes, as a high proportion of clinical decisions are based on routine tests and imaging results, which can be assessed remotely. The uptake of digital ophthalmology varies significantly between countries. Due to financial constraints within the National Health Service, specialized ophthalmology units in the UK have been early adopters of digital technology. For more than a decade, patients have been managed remotely in the diabetic retinopathy screening service and virtual glaucoma clinics. We describe the day-to-day running of such services and the doctor and patient experiences with digital ophthalmology in daily practice.

Training and accreditation for retinal screening and grading

2020 ◽  
pp. 139-144
Author(s):  
Karen Whitehouse
Keyword(s):  
Slit Lamp ◽  
Slit Lamp Examination ◽  
Eye Screening ◽  
Current Requirement ◽  
Vocational Qualifications ◽  
Level 3 ◽  
Test Sets ◽  
Diabetic Eye Screening ◽  
The Uk ◽  
And Training

In all national screening programmes, staff training to confirm competency and accreditation to practice in their profession is required for patient safety. This chapter sets out an example of how the UK diabetic eye programme has evolved in this respect. The current National Vocational Qualifications (NVQ) level 3: Health screener: diabetic eye screening for personnel undertaking screening and grading, will be explained. In some programmes, slit lamp examination is now provided by graders, as well as ophthalmologists and optometrists. The current requirement is detailed. In addition, all grading staff should also participate in test and training of retinal image sets in order to confirm accuracy of grading. At least 10 test sets should be undertaken per annum.

The NHS diabetic eye screening programme

2019 ◽  
Vol 13 (12) ◽  
pp. 596-599
Author(s):  
Ian Peate
Keyword(s):  
Healthy Lifestyle ◽  
False Negative ◽  
Young Person ◽  
Screening Process ◽  
Negative Results ◽  
Eye Screening ◽  
Increased Risk ◽  
Diabetic Eye Screening ◽  
The Individual ◽  
The Uk

The NHS diabetic eye screening (DES) programme is one of the young person and adult NHS population screening programmes that are available in the UK. The various NHS screening programmes identify those people who appear healthy, but could be at increased risk of a disease or condition. Screening is not the same as diagnosis and there will always be a possibility of some false positive and false negative results. This article in the series provides the reader with details about the DES programme. A brief overview of the anatomy of the eye is provided and the screening process is described. The healthcare assistant and assistant practitioner (HCA and AP) have a key role to play in encouraging and emphasising the importance of screening, as well as helping the individual maintain a healthy lifestyle.

scholarly journals Diagnosis of retinopathy in children younger than 12 years of age: implications for the diabetic eye screening guidelines in the UK

Eye ◽  
2016 ◽  
Vol 30 (7) ◽  
pp. 949-951 ◽  
Author(s):  
A Hamid ◽  
H M Wharton ◽  
A Mills ◽  
J M Gibson ◽  
M Clarke ◽  
...  
Keyword(s):  
Screening Guidelines ◽  
Eye Screening ◽  
Diabetic Eye Screening ◽  
The Uk
Sign in / Sign up

Export Citation Format

Share Document