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title:Magnitude and Determinants of Noncompliance for Screening and Management of Diabetic Retinopathy

Author:Khurshed M Bharucha, Kuldeep Dole, Kunal Bhadbhade, Rahul Deshpande, Madan Deshpande

Keywords:Diabetic Retinopathy; Laser treatment; Noncompliance; Barriers.

Type:Original Article

Abstract:"Introduction: Strategies to reduce visual disabilities due to diabetic retinopathy (DR) include early detection and prompt management. Patient compliance is a crucial a factor to achieve this goal. The aim of the study is to assess the level of noncompliance among diabetic patients towards diabetic retinopathy screening and towards undergoing suggested ophthalmic interventions. Methodology: Diabetic patients presenting to the tertiary eye hospital of Western India were divided into 2 groups: diabetic retinopathy (DR) screening group (SGR) and diabetic patients with sight threatening (STDR) who were advised intervention (DR treatment group) (TR GR). All patients were interviewed to determine the level of noncompliance and barriers perceived towards noncompliance. P<0.05 was statistically significant. Results: There were 75 diabetics in SGR and 72 in TR GR. The rate of noncompliance for DR screening was 64% [95% confidence interval (CI):53.1 – 74.9]. The rate of non-compliance for treatment for DR was 56.9% (95%CI 45.5 – 68.3). Rural residents (P=0.03) were statistically significantly more noncompliant towards DR screening. The best-corrected visual acuity in the better eye was associated to noncompliance to STDR treatment (P=0.001)while severity of DR was associated to the noncompliance for DR screening (P=0.05). Conclusions: Noncompliance towards periodic DR screening as well as recommended ophthalmic treatment among diabetic eye patients is high. Lack of knowledge, cost of intervention and distance to eyecare services were main perceived barriers. Public health strategies to address these barriers could improve compliance for periodic DR screening and STDR management. "

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