Aims

To estimate the uptake of diabetic retinopathy screening among adults with type 2 diabetes and to identify and compare factors associated with attendance at the national diabetic retinal screening programme, and other screening services provided by ophthalmic surgeons, community ophthalmologists and optometrists.

Methods

An observational retrospective cohort study was carried out using data from the 2016 audit of care delivered by general practices (n = 30) enrolled in a structured diabetes care initiative.

Attendance at any screening in the previous 12 months, and attendance across different types of service (national programme and other screening services) was calculated. Logistic regression was performed to examine predictors associated with (1) attendance at any screening and (2) attendance at the national programme (RetinaScreen). Sociodemographic, clinical, and lifestyle factors were examined as predictors.

Results

Data were available for 1106 people with type 2 diabetes aged ≥18 years.

Overall, 863 (78%) of patients had a record of screening attendance in the previous 12 months. Of those screened, 494 (57.2%) attended RetinaScreen only, 258 (28.7%) attended other screening services only, and 111 (12.9%) attended both services.

Statistically significant predictors of attendance at any screening were tablet/injectable controlled diabetes, attendance at a diabetes nurse specialist (DNS) in the past 12 months and a blood glucose level which was not on target (HbA1c >7.0% or >53 mmol/mol). In addition to these factors, when examining predictors of attendance at the national screening programme specifically, females were less likely to attend.

Conclusions

Most patients managed in a structured diabetes care programme in primary care attended screening. Those with on target blood glucose control, those who were on oral or injectable medication or had been seen by a DNS were more likely to attend for annual screening. Of those who attended screening, almost one-third attended other screening services and so were not availing of the national programme, which is free, quality assured and has an integrated treatment arm.

中文翻译：

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2型糖尿病患者参加糖尿病视网膜病变筛查的预测因素：初级保健数据的二次分析

目标

估计患有 2 型糖尿病的成年人中糖尿病视网膜病变筛查的接受情况，并确定和比较与参加国家糖尿病视网膜筛查计划以及眼外科医生、社区眼科医生和验光师提供的其他筛查服务相关的因素。

方法

使用 2016 年对参加结构化糖尿病护理计划的全科医师 (n = 30) 提供的护理进行审计的数据进行了一项观察性回顾性队列研究。

计算了过去 12 个月内任何筛查的出勤率，以及不同类型服务（国家计划和其他筛查服务）的出勤率。进行逻辑回归以检查与 (1) 参加任何筛查和 (2) 参加国家计划 (RetinaScreen) 相关的预测因素。社会人口统计学、临床和生活方式因素作为预测因素进行了检查。

结果

有 1106 名年龄≥18 岁的 2 型糖尿病患者的数据可用。

总体而言，863 名 (78%) 的患者在过去 12 个月内有筛查出勤记录。在接受筛查的人中，494 人 (57.2%) 只参加了 RetinaScreen，258 人 (28.7%) 只参加了其他筛查服务，111 人 (12.9%) 参加了这两项服务。

任何筛查出勤率的统计学显着预测因素是片剂/注射控制糖尿病、过去 12 个月内就诊于糖尿病专科护士 (DNS) 以及血糖水平未达标（HbA1c >7.0% 或 >53 mmol/mol ）。除了这些因素之外，在专门检查国家筛查项目的出勤预测因素时，女性出勤率较低。

结论

大多数在初级保健中接受结构化糖尿病护理计划管理的患者都参加了筛查。血糖控制达标的人、口服或注射药物的人或接受过 DNS 检查的人更有可能参加年度筛查。在参加筛查的人中，几乎三分之一的人参加了其他筛查服务，因此没有利用国家计划，该计划是免费的、质量有保证的并且有一个综合治疗部门。