O'Keeffe Dara, Riordan Fiona, Harkins Velma, Kearney Patricia, Mc Hugh Sheena
School of Public Health, University College Cork, Ireland.
School of Public Health, University College Cork, Ireland.
Prim Care Diabetes. 2021 Dec;15(6):1086-1094. doi: 10.1016/j.pcd.2021.08.004. Epub 2021 Sep 11.
To estimate the uptake of diabetic retinopathy screening among adults with type 2 diabetes and to identify and compare factors associated with attendance at the national diabetic retinal screening programme, and other screening services provided by ophthalmic surgeons, community ophthalmologists and optometrists.
An observational retrospective cohort study was carried out using data from the 2016 audit of care delivered by general practices (n = 30) enrolled in a structured diabetes care initiative. Attendance at any screening in the previous 12 months, and attendance across different types of service (national programme and other screening services) was calculated. Logistic regression was performed to examine predictors associated with (1) attendance at any screening and (2) attendance at the national programme (RetinaScreen). Sociodemographic, clinical, and lifestyle factors were examined as predictors.
Data were available for 1106 people with type 2 diabetes aged ≥18 years. Overall, 863 (78%) of patients had a record of screening attendance in the previous 12 months. Of those screened, 494 (57.2%) attended RetinaScreen only, 258 (28.7%) attended other screening services only, and 111 (12.9%) attended both services. Statistically significant predictors of attendance at any screening were tablet/injectable controlled diabetes, attendance at a diabetes nurse specialist (DNS) in the past 12 months and a blood glucose level which was not on target (HbA1c >7.0% or >53 mmol/mol). In addition to these factors, when examining predictors of attendance at the national screening programme specifically, females were less likely to attend.
Most patients managed in a structured diabetes care programme in primary care attended screening. Those with on target blood glucose control, those who were on oral or injectable medication or had been seen by a DNS were more likely to attend for annual screening. Of those who attended screening, almost one-third attended other screening services and so were not availing of the national programme, which is free, quality assured and has an integrated treatment arm.
评估2型糖尿病成人患者中糖尿病视网膜病变筛查的接受情况，并识别和比较与参加国家糖尿病视网膜筛查计划以及眼科外科医生、社区眼科医生和验光师提供的其他筛查服务相关的因素。
采用参与结构化糖尿病护理倡议的30家全科诊所2016年护理审计数据进行一项观察性回顾性队列研究。计算过去12个月内参加任何筛查的情况以及不同类型服务（国家计划和其他筛查服务）的参与情况。进行逻辑回归分析以检查与（1）参加任何筛查和（2）参加国家计划（视网膜筛查）相关的预测因素。将社会人口学、临床和生活方式因素作为预测因素进行检查。
获得了1106名年龄≥18岁的2型糖尿病患者的数据。总体而言，863名（78%）患者在过去12个月有筛查记录。在接受筛查的患者中，494名（57.2%）仅参加了视网膜筛查，258名（28.7%）仅参加了其他筛查服务，111名（12.9%）参加了两种服务。参加任何筛查的统计学显著预测因素为使用片剂/注射剂控制糖尿病、过去12个月内就诊于糖尿病专科护士以及血糖水平未达标（糖化血红蛋白>7.0%或>53 mmol/mol）。除这些因素外，在专门检查参加国家筛查计划的预测因素时，女性参加的可能性较小。
在初级保健的结构化糖尿病护理计划中管理的大多数患者参加了筛查。血糖控制达标、使用口服或注射药物或就诊于糖尿病专科护士的患者更有可能参加年度筛查。在参加筛查的患者中，近三分之一参加了其他筛查服务，因此未利用免费、质量有保障且有综合治疗环节的国家计划。
