scholarly journals Eye-care utilization among a Canadian diabetic refugee population: retrospective cohort study of an interdisciplinary care model

2021 ◽  
pp. 205343452110610
Author(s):  
Stuti M Tanya ◽  
Bonnie He ◽  
Christine Aubrey-Bassler
Keyword(s):  
Retrospective Cohort ◽  
Care Delivery ◽  
Family Physicians ◽  
Care Utilization ◽  
Vision Screening ◽  
Care Providers ◽  
Eye Care ◽  
Settlement Services ◽  
Screening Services ◽  
Eye Care Utilization

Introduction Vision health is an important and underutilized health service among newly arrived refugees in Canada, yet the body of literature on eye-care delivery in this population is limited. The study objective was to identify patterns of eye-care utilization among refugee patients with type 2 diabetes mellitus (T2DM) in Newfoundland and Labrador (NL) under an interdisciplinary clinic model comprised of family physicians, eye-care providers, and settlement services. Methods This was a retrospective cohort study at the Memorial University Family Medicine clinic. All patients with a new T2DM diagnosis between 2015–2020 were included. Data were described using basic statistics and unpaired t-tests. This study received full ethics approval. Results Seventy-three (18 refugee, 55 non-refugee) patients were included. Refugees had a higher rate of referral to an eye-care provider ( p = 0.0475) and were more likely to attend their eye-care provider appointment than non-refugees ( p = 0.016). The time from diagnosis to referral was longer for refugees than non-refugees ( p = 0.0498). A trend towards longer time from referral to appointment attendance for refugees than non-refugees was noted ( p = 0.9069). Discussion Refugee patients had higher rates of referral to eye-care providers and utilization of eye-care services. However, refugees also experienced a longer time to access vision screening services suggesting possible gaps in accessible care delivery. This suggests that the interdisciplinary model of care may be effective in referring refugee patients for vision screening and there may be a role for increased collaboration across family physicians, eye-care providers, and settlement services to improve accessibility of vision screening services.

scholarly journals Eye-care Utilization Among a Canadian Diabetic Refugee Population: A Retrospective Cohort Pilot Study

2021 ◽  
Author(s):  
Stuti M Tanya ◽  
Bonnie He ◽  
Christine Aubrey-Bassler
Keyword(s):  
Newfoundland And Labrador ◽  
Primary Care Providers ◽  
Small Sample ◽  
Care Utilization ◽  
Study Cohort ◽  
Vision Screening ◽  
Care Providers ◽  
Eye Care ◽  
Refugee Population ◽  
Eye Care Utilization

Abstract Background: Diabetic retinopathy (DR) is a leading and preventable cause of blindness. DR screening lies at the intersection of many documented challenges in access to care for refugees. Additionally, vision screening is determined to be an important health need and a critical locus for underutilization of health services among refugees resettling in Canada. To date, there is a limited body of evidence on the ocular health of refugees in Canada and no known studies on diabetic vision screening among refugees. Our objective was to identify patterns of eye-care utilization among refugee and non-refugee patients with type 2 diabetes mellitus (T2DM) in Newfoundland and Labrador (NL).Methods: We conducted a retrospective comparative cohort study at the Memorial University Family Medicine clinic, which includes the province’s largest dedicated refugee clinic. All patients with a new T2DM diagnosis between 2015-2020 were included. Data were described using basic statistics and unpaired t-tests. This study received full approval from the Newfoundland and Labrador Health Research Ethics Board. Results: 73 (18 refugee, 55 non-refugee) patients were included. Refugees had a significantly higher rate of referral to an eye-care provider (ECP) (p=0.0475) and were more likely to attend their ECP appointment than non-refugees (p=0.016). The time from diagnosis to referral was significantly longer for refugees than non-refugees (p=0.0498). A trend towards a longer time from referral to appointment attendance for refugees than non-refugees was noted (p=0.9069). Conclusions: Our study is the first to report eye-care utilization among an Atlantic Canadian refugee population, and among the first to report access to diabetic vision care among refugees worldwide. Although refugee patients in our study cohort had higher rates of referral to ECPs and utilization of eye-care services, they also experienced a longer time to access care. Specialist care is known to be more challenging to access for vulnerable populations. Our findings suggest that there may be a role for ECPs to collaborate with primary care providers to improve access to vision screening services. Limitations include the small sample size as well as selection and detection bias inherent to a retrospective chart review.

scholarly journals School-based vision screening in Quetta, Pakistan: a qualitative study of experiences of teachers and eye care providers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stevens Bechange ◽  
Munazza Gillani ◽  
Emma Jolley ◽  
Robina Iqbal ◽  
Leena Ahmed ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Screening Programme ◽  
Public Health Problem ◽  
Care Hospital ◽  
Vision Screening ◽  
Care Providers ◽  
Eye Care ◽  
Training Experience ◽  
Screening Guidelines ◽  
School Based

Abstract Background Visual impairment in children is a significant public health problem affecting millions of children globally. Many eye problems experienced by children can be easily diagnosed and treated. We conducted a qualitative study with teachers and optometrists involved in a school-based vision screening programme in Quetta district of Pakistan to explore their experiences of training, vision screening and referrals and to identify factors impacting on the effectiveness of the programme. Methods Between April 2018 and June 2018, we conducted semi-structured in-depth interviews with 14 teachers from eight purposefully selected schools with high rates of inaccurate (false positive) referrals. Interviews were also conducted with three optometrists from a not-for profit private eye care hospital that had trained the teachers. Interviews were audio recorded and professionally transcribed. NVIVO software version 12 was used to code and thematically analyze the data. Results Findings suggest that the importance of school-based vision screening was well understood and appreciated by the teachers and optometrists. Most participants felt that there was a strong level of support for the vision screening programme within the participating schools. However, there were a number of operational issues undermining the quality of screening. Eight teachers felt that the duration of the training was insufficient; the training was rushed; six teachers said that the procedures were not sufficiently explained, and the teachers had no time to practice. The screening protocol was not always followed by the teachers. Additionally, many teachers reported being overburdened with other work, which affected both their levels of participation in the training and the time they spent on the screening. Conclusions School-based vision screening by teachers is a cost-effective strategy to detect and treat children’s vision impairment early on. In the programme reviewed here however, a significant number of teachers over referred children to ophthalmic services, overwhelming their capacity and undermining the efficiency of the approach. To maximise the effectiveness and efficiency of school-based screening, future initiatives should give sufficient attention to the duration of the teacher training, experience of trainers, support supervision, refresher trainings, regular use of the screening guidelines, and the workload and motivation of those trained.

scholarly journals LOWER RATES OF EYE CARE UTILIZATION AMONG VISUALLY IMPAIRED SUBSIDIZED SENIOR HOUSING RESIDENTS

2018 ◽  
Vol 2 (suppl_1) ◽  
pp. 498-498
Author(s):  
A Elliott ◽  
M Heskett ◽  
G McGwin Jr ◽  
C Owsley
Keyword(s):  
Visually Impaired ◽  
Care Utilization ◽  
Eye Care ◽  
Senior Housing ◽  
Eye Care Utilization

Determinants of Eye Care Utilization in Rural South-eastern Nigeria

2015 ◽  
Vol 40 (5) ◽  
pp. 881-890 ◽  
Author(s):  
O. C. Arinze ◽  
B. I. Eze ◽  
N. N. Ude ◽  
S. N. Onwubiko ◽  
C. N. Ezisi ◽  
...  
Keyword(s):  
Care Utilization ◽  
Eye Care ◽  
Rural South ◽  
South Eastern ◽  
Eye Care Utilization

scholarly journals Low rates of eye care utilization among visually impaired subsidized senior housing residents

2019 ◽  
pp. 1-7
Author(s):  
Amanda F. Elliott ◽  
Megan Heskett ◽  
Christopher Spiker ◽  
Gerald McGwin ◽  
Cynthia Owsley
Keyword(s):  
Visually Impaired ◽  
Care Utilization ◽  
Eye Care ◽  
Senior Housing ◽  
Eye Care Utilization

Factors Associated With Visual Impairment and Eye Care Utilization: The International Mobility in Aging Study

2017 ◽  
Vol 30 (9) ◽  
pp. 1369-1388 ◽  
Author(s):  
Safari Balegamire ◽  
Marie-Josée Aubin ◽  
Carmen-Lucia Curcio ◽  
Beatriz Alvarado ◽  
Ricardo O. Guerra ◽  
...  
Keyword(s):  
Domestic Violence ◽  
Visual Impairment ◽  
Prevalence Ratio ◽  
Care Utilization ◽  
International Mobility ◽  
Eye Care ◽  
Factors Associated ◽  
Aging Study ◽  
Eye Care Utilization ◽  
Violence Prevalence

Objective:To examine factors associated with visual impairment (VI) and eye care in the International Mobility in Aging Study (IMIAS). Method: IMIAS data were analyzed ( N = 1,995 with ages 65-74). Outcomes were VI defined as presenting visual acuity worse than 6/18 in the better eye and eye care utilization assessed by annual visits to eye care professionals. The Hurt–Insult–Threaten–Scream (HITS) questionnaire requested information on domestic violence. Results: Among men, VI varied from 24% in Manizales (Colombia) to 0.5% in Kingston (Canada); among women, VI ranged from 20% in Manizales to 1% in Kingston; lifetime exposure to domestic violence was associated with VI (odds ratio [OR] = 1.87; 95% confidence interval [CI] = [1.17, 3.00]). Eye care utilization varied from 72% in Kingston’s men to 25% in Tirana’s men; it was associated with domestic violence (prevalence ratio [PR] = 1.3; 95% CI = [1.1, 1.6]). Discussion: VI is more frequent where eye care utilization is low. Domestic violence may be a risk factor for VI.

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