Zhou Yifan, Li Xiaowen, Sun Qinglei, Wei Jin, Liu Haiyun, Wang Keyan, Luo Jianfeng
Department of Ophthalmology, Putuo People's Hospital, Tongji University, Shanghai 200060, China.
Department of Biostatistics, School of Public Health, Fudan University, Shanghai 200032, China.
J Clin Med. 2022 Nov 21;11(22):6859. doi: 10.3390/jcm11226859.
Adherence to annual fundus examinations in the Chinese population with diabetes and its correlates have not been investigated. The present study obtained data for the first nationally representative survey in China, China Health and Retirement Longitudinal Survey (CHARLS), which collected a wide range of data every 2 years, including demographic, socioeconomic, medical and lifestyle-related information. The adherence rates to annual fundus exams across four waves (2011−2018) were assessed. Univariate and multivariable logistic regressions were used to determine factors associated with adherence. The adherence rates to annual fundus examinations of ou study population were 23.6% in 2011, 15.3% in 2013, 17.5% in 2015 and 21.5% in 2018, respectively. Consistent results over four waves showed that non-adherent patients had a relatively lower educational level, insufficient diabetes medication use, fewer non-medication treatments and irregular physical examination compared to those who were adherent to the annual fundus exam (all p values < 0.05). These variables were further identified as factors associated with adherence according to univariate and multivariate logistic regression analyses (all p values < 0.05). The present study provides explicit evidence that the adherence rate to annual fundus examinations among Chinese population with diabetes is worryingly low. Insufficient educational attainment, especially specific diabetes education, has a negative impact on patients’ adherence to clinical guideline for eye health.
中国糖尿病患者对年度眼底检查的依从性及其相关因素尚未得到研究。本研究获取了中国首次具有全国代表性的调查——中国健康与养老追踪调查（CHARLS）的数据，该调查每两年收集广泛的数据，包括人口统计学、社会经济、医疗和生活方式相关信息。评估了四期（2011 - 2018年）年度眼底检查的依从率。采用单因素和多因素逻辑回归来确定与依从性相关的因素。本研究人群年度眼底检查的依从率在2011年为23.6%，2013年为15.3%，2015年为17.5%，2018年为21.5%。四期的一致结果表明，与坚持年度眼底检查的患者相比，未坚持的患者教育水平相对较低、糖尿病药物使用不足、非药物治疗较少且体检不规律（所有p值<0.05）。根据单因素和多因素逻辑回归分析，这些变量进一步被确定为与依从性相关的因素（所有p值<0.05）。本研究提供了明确的证据，表明中国糖尿病患者年度眼底检查的依从率低得令人担忧。教育程度不足，尤其是特定的糖尿病教育，对患者遵守眼部健康临床指南有负面影响。
