Pardhan Shahina, Wijewickrama Rumalie Chanika Alwis, Gilbert Clare E, Piyasena Mapa Prabhath, Sapkota Raju
Vision and Eye Research Institute, School of Medicine, Anglia Ruskin University, Cambridge, UK
Centre for Inclusive Community Eye Health, School of Medicine, Anglia Ruskin University, Cambridge, UK.
BMJ Open. 2024 Dec 27;14(12):e089710. doi: 10.1136/bmjopen-2024-089710.
This study aims to examine the reduction and subsequent recovery of routine digital screening (RDS) uptake in England from 2018 to 2022, exploring national, regional and individual Diabetic Eye Screening Programme (DESP) levels. The COVID-19 lockdown in most areas of England was from 26 March 2020 to 23 June 2020 (first national lockdown), 5 November 2020 to 2 December 2020 (second national lockdown) and 6 January 2021 to 8 March 2021 (third national lockdown).
Retrospective data analysis.
DESPs of England.
Individuals with diabetes who were invited to take part in the DESP programmes.
Publicly available data from Public Health England (2018-2019) and National Health Service England (2019-2022) were examined to identify the rate of uptake (proportion of those who attended the DESPs to those who were invited) of RDS at national and regional levels and by each DESP in England.
Rate of uptake of RDS.
The national uptake of RDS decreased from 82% (2019-2020) to 68% (2020-2021) and then increased to 78% (2021-2022). At the regional level, the sharpest drop was in the Midlands which decreased from 79% (2019-2020) to 53% (2020-2021), increasing to 73% (2021-2022) but did not reach pre-COVID-19 levels. At individual DESP levels across England, the greatest drop in attendance (2020-2021) was recorded in Derbyshire (79% to 45%), Barnsley and Rotherham (78% to 45%) and Arden, Herefordshire and Worcestershire (78% to 46%). Although these DESPs showed an increase in 2021-2022 of 33%, 21% and 31%, they did not reach prepandemic (2018-2019) rates of 81%, 85% and 82%, respectively. Data suggest that West Sussex, East Sussex and East and North Hertfordshire DESPs maintained relatively higher uptake rates (86%-89%) in 2020-2021.
COVID-19 had an impact on England's diabetic eye screening attendance, with notable variations across regions and DESPs. Different regions and DESPs showed variable post-COVID-19 recovery. More importantly, what was not evident is the increased uptake that should have occurred after the COVID-19 lockdown to compensate for the low uptake during the lockdown. In some areas, addressing some of the barriers that affect retinal screening uptake may improve future attendance.
本研究旨在调查2018年至2022年英格兰常规数字筛查（RDS）接受率的下降及随后的恢复情况，探讨国家、地区和糖尿病眼部筛查项目（DESP）个体层面的情况。英格兰大部分地区的新冠疫情封锁时间为2020年3月26日至2020年6月23日（第一次全国封锁）、2020年11月5日至2020年12月2日（第二次全国封锁）以及2021年1月6日至2021年3月8日（第三次全国封锁）。
回顾性数据分析。
英格兰的糖尿病眼部筛查项目。
被邀请参加糖尿病眼部筛查项目的糖尿病患者。
研究了英国公共卫生部（2018 - 2019年）和英国国家医疗服务体系（2019 - 2022年）公开的数据，以确定国家和地区层面以及英格兰每个糖尿病眼部筛查项目中RDS的接受率（参加糖尿病眼部筛查项目的人数占被邀请人数的比例）。
RDS的接受率。
RDS的全国接受率从82%（2019 - 2020年）降至68%（2020 - 2021年），随后升至78%（2021 - 2022年）。在地区层面，降幅最大的是中部地区，从79%（2019 - 2020年）降至53%（2020 - 2021年），升至73%（2021 - 2022年），但未恢复到新冠疫情前的水平。在英格兰各地的糖尿病眼部筛查项目个体层面，出席率下降幅度最大的（2020 - 2021年）是德比郡（从79%降至45%）、巴恩斯利和罗瑟勒姆（从78%降至45%）以及阿登、赫里福德郡和伍斯特郡（从78%降至46%）。尽管这些糖尿病眼部筛查项目在2021 - 2022年分别增长了33%、21%和31%，但未达到疫情前（2018 - 2019年）81%、85%和82%的比率。数据表明，西苏塞克斯、东苏塞克斯以及东赫特福德郡和北赫特福德郡的糖尿病眼部筛查项目在2020 - 2021年保持了相对较高的接受率（86% - 89%）。
新冠疫情对英格兰糖尿病眼部筛查的出席率产生了影响，不同地区和糖尿病眼部筛查项目存在显著差异。不同地区和糖尿病眼部筛查项目在新冠疫情后的恢复情况各不相同。更重要的是，不明显的是在新冠疫情封锁后接受率应有所提高以弥补封锁期间的低接受率。在一些地区，解决影响视网膜筛查接受率的一些障碍可能会提高未来的出席率。
