Centre for Eye Research Australia, Melbourne, VIC
Centre for Eye Research Australia, Melbourne, VIC.
Med J Aust. 2017 May 15;206(9):402-406. doi: 10.5694/mja16.00989.
To determine adherence to NHMRC eye examination guidelines for Indigenous and non-Indigenous Australian people with diabetes.
Cross-sectional survey using multistage, random cluster sampling.
Thirty randomly selected geographic sites in the five mainland Australian states and the Northern Territory, stratified by remoteness.
1738 Indigenous Australians aged 40-92 years and 3098 non-Indigenous Australians aged 50-98 years were recruited and examined between March 2015 and April 2016 according to a standardised protocol that included a questionnaire (administered by an interviewer) and a series of standard eye tests.
Adherence rates to NHMRC eye examination guidelines; factors influencing adherence.
Adherence to screening recommendations was significantly greater among non-Indigenous Australians (biennial screening; 77.5%) than Indigenous Australians (annual screening; 52.7%; P < 0.001). Greater adherence by non-Indigenous Australians was associated with longer duration of diabetes (adjusted odds ratio [aOR], 1.19 per 5 years; P = 0.018), while increasing age was associated with poorer adherence in non-Indigenous Australians (aOR, 0.70 per decade; P = 0.011). For Indigenous Australians, residing in inner regional areas (aOR, 1.66; P = 0.007) and being male (aOR, 1.46; P = 0.018) were significant factors positively associated with adherence.
More than three-quarters of non-Indigenous Australians with diabetes and more than half of Indigenous Australians with diabetes adhere to the NHMRC eye examination guidelines. The discrepancy between the adherence rates may point to gaps in the provision or uptake of screening services in Indigenous communities, or a lack of awareness of the guidelines. A carefully integrated diabetic retinopathy screening service is needed, particularly in remote areas, to improve adherence rates.
确定澳大利亚原住民和非原住民糖尿病患者是否遵循 NHMRC 眼部检查指南。
使用多阶段、随机聚类抽样的横断面调查。
在澳大利亚五个大陆州和北领地的 30 个随机选定的地理地点进行，根据偏远程度进行分层。
根据标准化方案招募并检查了 1738 名年龄在 40-92 岁之间的澳大利亚原住民和 3098 名年龄在 50-98 岁之间的非原住民澳大利亚人，该方案包括问卷调查（由访谈员进行）和一系列标准眼部检查。
NHMRC 眼部检查指南的依从率；影响依从性的因素。
非原住民澳大利亚人（每两年筛查一次；77.5%）遵循筛查建议的比例明显高于原住民澳大利亚人（每年筛查一次；52.7%；P<0.001）。非原住民澳大利亚人更高的依从性与糖尿病持续时间较长相关（调整后的优势比[OR]，每 5 年增加 1.19；P=0.018），而年龄增长与非原住民澳大利亚人的依从性较差相关（OR，每 10 年降低 0.70；P=0.011）。对于原住民澳大利亚人，居住在内陆地区（OR，1.66；P=0.007）和男性（OR，1.46；P=0.018）是与依从性呈正相关的显著因素。
超过 3/4 的非原住民澳大利亚糖尿病患者和超过一半的原住民澳大利亚糖尿病患者遵循 NHMRC 眼部检查指南。这种依从率之间的差异可能表明在原住民社区中筛查服务的提供或采用存在差距，或者是对指南缺乏认识。需要一种精心整合的糖尿病视网膜病变筛查服务，特别是在偏远地区，以提高依从率。
