Factors associated with compliance following diabetic eye screening.

Compliance with screening recommendations was evaluated following an eye examination administered to a population-based sample of diabetic individuals (The Wisconsin Epidemiologic Study of Diabetic Retinopathy). The relationship between certain characteristics and compliance with a recommendation to seek ophthalmologic follow-up care was examined among 819 study subjects found to have retinopathy at examination. Compliance with the screening recommendations was reported by 77% of all subjects, and was lowest among older-onset non-insulin taking subjects (65%). A history of ophthalmologic care strongly influenced compliance. Subjects who had never seen an ophthalmologist were far less likely to follow the recommendation (50%) than were those who had seen an ophthalmologist in the previous two years (87%). A previous diagnosis of retinopathy, and more severe retinopathy, were determinants of compliance among subjects taking insulin. Increasing duration of diabetes was also an important predictor. Better blood glucose control was found more frequently among subjects who received the recommended ophthalmologic follow-up. Certain demographic factors, such as increasing age, higher education, and being a woman, were associated with compliance in the younger-onset group. Among older-onset non-insulin taking subjects, compliance was more likely if subjects were urban residents. In order to optimize the effectiveness of a screening program for diabetic eye disease, the results of this study might be used to identify subjects who may be unlikely to receive appropriate diagnosis and treatment following screening.