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Murchison AP, Hark L, Pizzi LT, et al. Non-adherence to eye care in people with diabetes. BMJ Open Diabetes Res Care. 2017;5(1):e000333doi: 10.1136/bmjdrc-2016-000333.
Murchison, A. P., Hark, L., Pizzi, L. T., Dai, Y., Mayro, E. L., Storey, P. P., Leiby, B. E., & Haller, J. A. (2017). Non-adherence to eye care in people with diabetes. BMJ open diabetes research & care, 5(1), e000333. https://doi.org/10.1136/bmjdrc-2016-000333
Murchison, Ann P, et al. "Non-adherence to eye care in people with diabetes." BMJ open diabetes research & care vol. 5,1 (2017): e000333. doi: https://doi.org/10.1136/bmjdrc-2016-000333
Murchison AP, Hark L, Pizzi LT, Dai Y, Mayro EL, Storey PP, Leiby BE, Haller JA. Non-adherence to eye care in people with diabetes. BMJ Open Diabetes Res Care. 2017 Jul 31;5(1):e000333. doi: 10.1136/bmjdrc-2016-000333. eCollection 2017. PMID: 28878930; PMCID: PMC5574424.
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BMJ Open Diabetes Res Care. 2017 Jul 31;5(1):e000333. doi: 10.1136/bmjdrc-2016-000333. eCollection 2017.

Non-adherence to eye care in people with diabetes.

BMJ open diabetes research & care

Ann P Murchison, Lisa Hark, Laura T Pizzi, Yang Dai, Eileen L Mayro, Philip P Storey, Benjamin E Leiby, Julia A Haller

Affiliations

  1. Department of Research, Wills Eye Hospital, Philadelphia, Pennsylvania, USA.
  2. Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

PMID: 28878930 PMCID: PMC5574424 DOI: 10.1136/bmjdrc-2016-000333

Abstract

OBJECTIVE: Evaluate individual factors that impact adherence to eye care follow-up in patients with diabetes.

DESIGN AND METHODS: A 4-year retrospective chart review was conducted for 1968 patients with diabetes over age 40 from an urban academic center. Data collected included demographics, insurance, visual acuity, smoking status, medications, dates of dilated fundus examinations (DFE), and reported hemoglobin A1C and blood glucose levels. The primary outcome was timely DFE follow-up adherence following the initial eye exam visit.

RESULTS: Overall, 41.6% of patients adhered to initial follow-up eye care recommendations. Multivariable analysis demonstrated that patients with severe diabetic retinopathy (DR) were more adherent than patients with mild DR (OR 1.86). Other variables associated with increased adherence were visual impairment and reported A1C or blood glucose. Smoking was associated with decreased adherence. Ethnicity and insurance were also significantly associated with adherence. Longitudinal follow-up rates were influenced by additional factors, including ethnicity and neighborhood deprivation index.

CONCLUSIONS: Patients with moderate to severe DR and/or visual impairment were more likely to adhere to timely DFE follow-up. This could relate to the presence of visual symptoms and/or other systemic manifestations of diabetes. Smokers were less likely to adhere to timely DFE follow-up. One hypothesis is patients who smoke have other symptomatic health problems which patients prioritize over asymptomatic ocular disorders. In order to reduce vision loss from DR, practitioners should be aware that patients with mild and moderate DR, patients with normal vision, and smokers are at greater risk for poor follow-up eye care adherence.

Keywords: Adherence; Adult diabetes; Eye disease; Eye exam

Conflict of interest statement

Competing interests: None declared.

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