Evaluation of the initial implementation of a nationwide diabetic retinopathy screening programme in primary care: a multimethod study
Objectives The Australian Government funded a nationwide diabetic retinopathy screening programme to improve visual outcomes for people with diabetes. This study examined the benefits and barriers of the programme, image interpretation pathways and assessed the characteristics of people who had thei...
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BMJ Publishing Group
2021-08-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/11/8/e044805.full |
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| author | Barbara Zangerl Vincent Khou Muhammad Azaan Khan Ivy Wei Jiang Paula Katalinic Ashish Agar |
| author_facet | Barbara Zangerl Vincent Khou Muhammad Azaan Khan Ivy Wei Jiang Paula Katalinic Ashish Agar |
| author_sort | Barbara Zangerl |
| collection | DOAJ |
| description | Objectives The Australian Government funded a nationwide diabetic retinopathy screening programme to improve visual outcomes for people with diabetes. This study examined the benefits and barriers of the programme, image interpretation pathways and assessed the characteristics of people who had their fundus photos graded by a telereading service which was available as a part of the programme.Design Multimethod: survey and retrospective review of referral forms.Setting Twenty-two primary healthcare facilities from urban, regional, rural and remote areas of Australia, and one telereading service operated by a referral-only eye clinic in metropolitan Sydney, Australia.Participants Twenty-seven primary healthcare workers out of 110 contacted completed a survey, and 145 patient referrals were reviewed.Results Manifest qualitative content analysis showed that primary healthcare workers reported that the benefits of the screening programme included improved patient outcomes and increased awareness and knowledge of diabetic retinopathy. Barriers related to staffing issues and limited referral pathways. Image grading was performed by a variety of primary healthcare workers, with one responder indicating the utilisation of a diabetic retinopathy reading service. Of the people with fundus photos graded by the reading service, 26.2% were reported to have diabetes. Overall, 12.3% of eyes were diagnosed with diabetic retinopathy. Photo quality was rated as excellent in 46.2% of photos. Referral to an optometrist for diabetic retinopathy was recommended in 4.1% of cases, and to an ophthalmologist in 6.9% of cases.Conclusions This nationwide diabetic retinopathy screening programme was perceived to increase access to diabetic retinopathy screening in regional, rural and remote areas of Australia. The telereading service has diagnosed diabetic retinopathy and other ocular pathologies in images it has received. Key barriers, such as access to ophthalmologists and optometrists, must be overcome to improve visual outcomes. |
| format | Article |
| id | doaj-art-0b35510dbccb446bbb47d3581d79094b |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2021-08-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-0b35510dbccb446bbb47d3581d79094b2025-08-20T02:37:57ZengBMJ Publishing GroupBMJ Open2044-60552021-08-0111810.1136/bmjopen-2020-044805Evaluation of the initial implementation of a nationwide diabetic retinopathy screening programme in primary care: a multimethod studyBarbara Zangerl0Vincent Khou1Muhammad Azaan Khan2Ivy Wei Jiang3Paula Katalinic4Ashish Agar5Coronary Care Unit, Royal Prince Alfred Hospital, Sydney, NSW, AustraliaSchool of Optometry and Vision Science, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, AustraliaFaculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, AustraliaFaculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, AustraliaCentre for Eye Health, Sydney, New South Wales, AustraliaCentre for Eye Health, Sydney, New South Wales, AustraliaObjectives The Australian Government funded a nationwide diabetic retinopathy screening programme to improve visual outcomes for people with diabetes. This study examined the benefits and barriers of the programme, image interpretation pathways and assessed the characteristics of people who had their fundus photos graded by a telereading service which was available as a part of the programme.Design Multimethod: survey and retrospective review of referral forms.Setting Twenty-two primary healthcare facilities from urban, regional, rural and remote areas of Australia, and one telereading service operated by a referral-only eye clinic in metropolitan Sydney, Australia.Participants Twenty-seven primary healthcare workers out of 110 contacted completed a survey, and 145 patient referrals were reviewed.Results Manifest qualitative content analysis showed that primary healthcare workers reported that the benefits of the screening programme included improved patient outcomes and increased awareness and knowledge of diabetic retinopathy. Barriers related to staffing issues and limited referral pathways. Image grading was performed by a variety of primary healthcare workers, with one responder indicating the utilisation of a diabetic retinopathy reading service. Of the people with fundus photos graded by the reading service, 26.2% were reported to have diabetes. Overall, 12.3% of eyes were diagnosed with diabetic retinopathy. Photo quality was rated as excellent in 46.2% of photos. Referral to an optometrist for diabetic retinopathy was recommended in 4.1% of cases, and to an ophthalmologist in 6.9% of cases.Conclusions This nationwide diabetic retinopathy screening programme was perceived to increase access to diabetic retinopathy screening in regional, rural and remote areas of Australia. The telereading service has diagnosed diabetic retinopathy and other ocular pathologies in images it has received. Key barriers, such as access to ophthalmologists and optometrists, must be overcome to improve visual outcomes.https://bmjopen.bmj.com/content/11/8/e044805.full |
| spellingShingle | Barbara Zangerl Vincent Khou Muhammad Azaan Khan Ivy Wei Jiang Paula Katalinic Ashish Agar Evaluation of the initial implementation of a nationwide diabetic retinopathy screening programme in primary care: a multimethod study BMJ Open |
| title | Evaluation of the initial implementation of a nationwide diabetic retinopathy screening programme in primary care: a multimethod study |
| title_full | Evaluation of the initial implementation of a nationwide diabetic retinopathy screening programme in primary care: a multimethod study |
| title_fullStr | Evaluation of the initial implementation of a nationwide diabetic retinopathy screening programme in primary care: a multimethod study |
| title_full_unstemmed | Evaluation of the initial implementation of a nationwide diabetic retinopathy screening programme in primary care: a multimethod study |
| title_short | Evaluation of the initial implementation of a nationwide diabetic retinopathy screening programme in primary care: a multimethod study |
| title_sort | evaluation of the initial implementation of a nationwide diabetic retinopathy screening programme in primary care a multimethod study |
| url | https://bmjopen.bmj.com/content/11/8/e044805.full |
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