Health education improves referral compliance of persons with probable Diabetic Retinopathy: A randomized controlled trial.
<h4>Objective</h4>Lack of awareness about Diabetic Retinopathy (DR) is the most commonly cited reason why many persons with type 2 diabetes are non-compliant with referral instruction to undergo retinal screening. The purpose of this study was to evaluate the efficacy of a culturally, ge...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2020-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0242047 |
| _version_ | 1831729621278654464 |
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| author | Zara Khair Md Moshiur Rahman Kana Kazawa Yasmin Jahan Abu S G Faruque Mohammod Jobayer Chisti Michiko Moriyama |
| author_facet | Zara Khair Md Moshiur Rahman Kana Kazawa Yasmin Jahan Abu S G Faruque Mohammod Jobayer Chisti Michiko Moriyama |
| author_sort | Zara Khair |
| collection | DOAJ |
| description | <h4>Objective</h4>Lack of awareness about Diabetic Retinopathy (DR) is the most commonly cited reason why many persons with type 2 diabetes are non-compliant with referral instruction to undergo retinal screening. The purpose of this study was to evaluate the efficacy of a culturally, geographically and socially appropriate, locally adapted five-month-long health education on referral compliance of participants.<h4>Method</h4>A prospective randomized, open-label parallel group study was conducted on persons with type 2 diabetes who underwent basic eye screening at a diabetes hospital between September 2017 and August 2018. Participants who were noncompliant with referral instruction to visit a hospital for advanced DR management were randomly divided into health education intervention group (n = 143) and control group (n = 156). Both groups received information regarding DR and referral instruction at the diabetes hospital. The intervention group was provided personalized education followed by telephonic reminders. The primary endpoint was 'increase in referral compliance' and the secondary endpoint was 'increase in knowledge of DR'. Multivariate logistic regression model was used to identify significant predictors of compliance to referral.<h4>Results</h4>A total of nine participants dropped and 290 completed the post intervention survey. The compliance rate in intervention group was found to be significantly higher than the control group (64.3% vs 28.2%; OR 4.73; 95% CI 2.87-7.79; p<0.001). Participants in the intervention group acquired better knowledge on DR (p<0.05). Apart from intervention, referral compliance rate was also found to be significantly associated with participants' self-perception of vision problem (OR 2.02; 95% CI 1.02-4.01; p = 0.045) and participants' income (OR 1.24; 95% CI 1.06-1.44; p = 0.008).<h4>Discussion</h4>Our results suggest that intensive health education on DR should be integrated with diabetes education as it may result in significantly improved referral compliance. Outcomes may be sustainable if interventions are institutionalized at referral point.<h4>Trial registration</h4>Clinical Trials.gov (Registration # NCT03658980); https://clinicaltrials.gov/ct2/show/NCT03658980. |
| first_indexed | 2024-12-21T07:14:58Z |
| format | Article |
| id | doaj.art-2605706c1c3a4588baa86bb0dfa8f706 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-21T07:14:58Z |
| publishDate | 2020-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-2605706c1c3a4588baa86bb0dfa8f7062022-12-21T19:11:53ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-011511e024204710.1371/journal.pone.0242047Health education improves referral compliance of persons with probable Diabetic Retinopathy: A randomized controlled trial.Zara KhairMd Moshiur RahmanKana KazawaYasmin JahanAbu S G FaruqueMohammod Jobayer ChistiMichiko Moriyama<h4>Objective</h4>Lack of awareness about Diabetic Retinopathy (DR) is the most commonly cited reason why many persons with type 2 diabetes are non-compliant with referral instruction to undergo retinal screening. The purpose of this study was to evaluate the efficacy of a culturally, geographically and socially appropriate, locally adapted five-month-long health education on referral compliance of participants.<h4>Method</h4>A prospective randomized, open-label parallel group study was conducted on persons with type 2 diabetes who underwent basic eye screening at a diabetes hospital between September 2017 and August 2018. Participants who were noncompliant with referral instruction to visit a hospital for advanced DR management were randomly divided into health education intervention group (n = 143) and control group (n = 156). Both groups received information regarding DR and referral instruction at the diabetes hospital. The intervention group was provided personalized education followed by telephonic reminders. The primary endpoint was 'increase in referral compliance' and the secondary endpoint was 'increase in knowledge of DR'. Multivariate logistic regression model was used to identify significant predictors of compliance to referral.<h4>Results</h4>A total of nine participants dropped and 290 completed the post intervention survey. The compliance rate in intervention group was found to be significantly higher than the control group (64.3% vs 28.2%; OR 4.73; 95% CI 2.87-7.79; p<0.001). Participants in the intervention group acquired better knowledge on DR (p<0.05). Apart from intervention, referral compliance rate was also found to be significantly associated with participants' self-perception of vision problem (OR 2.02; 95% CI 1.02-4.01; p = 0.045) and participants' income (OR 1.24; 95% CI 1.06-1.44; p = 0.008).<h4>Discussion</h4>Our results suggest that intensive health education on DR should be integrated with diabetes education as it may result in significantly improved referral compliance. Outcomes may be sustainable if interventions are institutionalized at referral point.<h4>Trial registration</h4>Clinical Trials.gov (Registration # NCT03658980); https://clinicaltrials.gov/ct2/show/NCT03658980.https://doi.org/10.1371/journal.pone.0242047 |
| spellingShingle | Zara Khair Md Moshiur Rahman Kana Kazawa Yasmin Jahan Abu S G Faruque Mohammod Jobayer Chisti Michiko Moriyama Health education improves referral compliance of persons with probable Diabetic Retinopathy: A randomized controlled trial. PLoS ONE |
| title | Health education improves referral compliance of persons with probable Diabetic Retinopathy: A randomized controlled trial. |
| title_full | Health education improves referral compliance of persons with probable Diabetic Retinopathy: A randomized controlled trial. |
| title_fullStr | Health education improves referral compliance of persons with probable Diabetic Retinopathy: A randomized controlled trial. |
| title_full_unstemmed | Health education improves referral compliance of persons with probable Diabetic Retinopathy: A randomized controlled trial. |
| title_short | Health education improves referral compliance of persons with probable Diabetic Retinopathy: A randomized controlled trial. |
| title_sort | health education improves referral compliance of persons with probable diabetic retinopathy a randomized controlled trial |
| url | https://doi.org/10.1371/journal.pone.0242047 |
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