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Patterns of adherence to diabetes vision care guidelines: baseline findings from the Diabetic Retinopathy Awareness Program.
Ophthalmology. 2001 Mar; 108(3):563-71.O

Abstract

OBJECTIVES

(1) To describe baseline patterns of adherence to American Diabetes Association and American Academy of Ophthalmology vision care guidelines for diabetes in the Diabetic Retinopathy Awareness Program, and (2) to evaluate factors associated with nonadherence. This paper describes the baseline characteristics of a population enrolled in a prospective, randomized clinical trial.

DESIGN

Cross-sectional study.

PARTICIPANTS

Between October 1993 and May 1994, the study identified 2308 persons with diabetes, 18 years of age or older, who were residents of Suffolk County, New York, via a multimedia community-wide recruitment campaign.

INTERVENTION AND METHODS

Eligibility for the trial was determined during a 20-minute phone interview, which included questions about vision care practices; diabetes management; and knowledge, attitudes, and beliefs about diabetes, vision, and diabetic retinopathy. This paper describes these patient characteristics at baseline. Eligible patients would be randomized subsequently to a 2-year diabetes educational intervention arm, which included mailed packets and newsletters focused on vision care, or to a control nonintervention arm.

MAIN OUTCOME MEASURE

Nonadherence to guidelines at baseline was defined as the absence of a dilated eye examination during the year before recruitment into the study.

RESULTS

Of the 2308 persons interviewed, 813 (35%) did not follow the vision care guidelines; two thirds of this group reported no eye examination in the year before the interview, and one third had an undilated examination. Ophthalmologists performed 49% of the examinations in the nonadherent group, versus 86% in the adherent group. In logistic regression analyses, factors related to nonadherence were: younger age (odds ratio [OR] = 0.97), type 2 diabetes with or without insulin use (OR = 1.62 and 1.99, respectively), shorter diabetes duration (OR = 0.97), last eye examination performed by an optometrist (OR = 5.32) or other nonophthalmologist (OR = 4.29), less practical knowledge about diabetes (OR = 1.57), and no prior formal diabetes education (OR = 1.30).

CONCLUSIONS

Within this population, more than one third of participants had not been following vision care guidelines. Nonadherence was linked to several potentially modifiable factors; changes in these factors could enhance the early detection of diabetic retinopathy.

Authors+Show Affiliations

Department of Preventive Medicine, University Medical Center at Stony Brook, Stony Brook, New York 11794-8036, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

11237912

Citation

Schoenfeld, E R., et al. "Patterns of Adherence to Diabetes Vision Care Guidelines: Baseline Findings From the Diabetic Retinopathy Awareness Program." Ophthalmology, vol. 108, no. 3, 2001, pp. 563-71.
Schoenfeld ER, Greene JM, Wu SY, et al. Patterns of adherence to diabetes vision care guidelines: baseline findings from the Diabetic Retinopathy Awareness Program. Ophthalmology. 2001;108(3):563-71.
Schoenfeld, E. R., Greene, J. M., Wu, S. Y., & Leske, M. C. (2001). Patterns of adherence to diabetes vision care guidelines: baseline findings from the Diabetic Retinopathy Awareness Program. Ophthalmology, 108(3), 563-71.
Schoenfeld ER, et al. Patterns of Adherence to Diabetes Vision Care Guidelines: Baseline Findings From the Diabetic Retinopathy Awareness Program. Ophthalmology. 2001;108(3):563-71. PubMed PMID: 11237912.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Patterns of adherence to diabetes vision care guidelines: baseline findings from the Diabetic Retinopathy Awareness Program. AU - Schoenfeld,E R, AU - Greene,J M, AU - Wu,S Y, AU - Leske,M C, PY - 2001/3/10/pubmed PY - 2001/3/27/medline PY - 2001/3/10/entrez SP - 563 EP - 71 JF - Ophthalmology JO - Ophthalmology VL - 108 IS - 3 N2 - OBJECTIVES: (1) To describe baseline patterns of adherence to American Diabetes Association and American Academy of Ophthalmology vision care guidelines for diabetes in the Diabetic Retinopathy Awareness Program, and (2) to evaluate factors associated with nonadherence. This paper describes the baseline characteristics of a population enrolled in a prospective, randomized clinical trial. DESIGN: Cross-sectional study. PARTICIPANTS: Between October 1993 and May 1994, the study identified 2308 persons with diabetes, 18 years of age or older, who were residents of Suffolk County, New York, via a multimedia community-wide recruitment campaign. INTERVENTION AND METHODS: Eligibility for the trial was determined during a 20-minute phone interview, which included questions about vision care practices; diabetes management; and knowledge, attitudes, and beliefs about diabetes, vision, and diabetic retinopathy. This paper describes these patient characteristics at baseline. Eligible patients would be randomized subsequently to a 2-year diabetes educational intervention arm, which included mailed packets and newsletters focused on vision care, or to a control nonintervention arm. MAIN OUTCOME MEASURE: Nonadherence to guidelines at baseline was defined as the absence of a dilated eye examination during the year before recruitment into the study. RESULTS: Of the 2308 persons interviewed, 813 (35%) did not follow the vision care guidelines; two thirds of this group reported no eye examination in the year before the interview, and one third had an undilated examination. Ophthalmologists performed 49% of the examinations in the nonadherent group, versus 86% in the adherent group. In logistic regression analyses, factors related to nonadherence were: younger age (odds ratio [OR] = 0.97), type 2 diabetes with or without insulin use (OR = 1.62 and 1.99, respectively), shorter diabetes duration (OR = 0.97), last eye examination performed by an optometrist (OR = 5.32) or other nonophthalmologist (OR = 4.29), less practical knowledge about diabetes (OR = 1.57), and no prior formal diabetes education (OR = 1.30). CONCLUSIONS: Within this population, more than one third of participants had not been following vision care guidelines. Nonadherence was linked to several potentially modifiable factors; changes in these factors could enhance the early detection of diabetic retinopathy. SN - 0161-6420 UR - https://www.unboundmedicine.com/medline/citation/11237912/Patterns_of_adherence_to_diabetes_vision_care_guidelines:_baseline_findings_from_the_Diabetic_Retinopathy_Awareness_Program_ DB - PRIME DP - Unbound Medicine ER -