The Effect on Patients’ Visual Acuity and Grade, Secondary to Non-Attendance at Treatment Centers, Post Referral from Diabetic RetinaScreen Ireland
Joanne Harmon,1 Stephen Kelly,2 Robert Acheson,1 David Keegan,2 Shane McMahon,1 Helen Kavanagh,2 Louise O’Toole1 1NEC Care, Cork, Ireland; 2Diabetic RetinaScreen, Heath Service Executive, Dublin, IrelandCorrespondence: Louise O’Toole, NEC Care, 55 South Mall (2nd Floor), Cork, T12 RR44, Ireland, Tel...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2023-01-01
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| Series: | Clinical Ophthalmology |
| Subjects: | |
| Online Access: | https://www.dovepress.com/the-effect-on-patients-visual-acuity-and-grade-secondary-to-non-attend-peer-reviewed-fulltext-article-OPTH |
| _version_ | 1797954454435135488 |
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| author | Harmon J Kelly S Acheson R Keegan D McMahon S Kavanagh H O'Toole L |
| author_facet | Harmon J Kelly S Acheson R Keegan D McMahon S Kavanagh H O'Toole L |
| author_sort | Harmon J |
| collection | DOAJ |
| description | Joanne Harmon,1 Stephen Kelly,2 Robert Acheson,1 David Keegan,2 Shane McMahon,1 Helen Kavanagh,2 Louise O’Toole1 1NEC Care, Cork, Ireland; 2Diabetic RetinaScreen, Heath Service Executive, Dublin, IrelandCorrespondence: Louise O’Toole, NEC Care, 55 South Mall (2nd Floor), Cork, T12 RR44, Ireland, Tel +35318858656, Fax +35318858658, Email lotoole@materprivate.ieBackground: Patient non-attendance following referral to hospital is a significant challenge, in particular, for persons with diabetes.Aim: We sought to determine the impact on both visual acuity and the subsequent follow-up retinopathy grade of patients when they fail to attend Diabetic Retinopathy Treatment (DRT) Centers following referral from Diabetic RetinaScreen (DRS).Methods: A retrospective analysis of patients discharged from DRT due to multiple consecutive missed appointments between January 2016 and June 2021. Patients discharged for non-attendance were compared with patients discharged from completed treatment.Results: Of the 24,945 NEC patients referred to DRT, 5900 (24%) and 9345 (37%) were discharged back to DRS due to non-attendance and completed treatment, respectively. Those discharged for non-attendance were younger (60.7 v 63.4, p < 0.001) and had higher proportions of males (67% v 63%, p < 0.001) and people with type 1 diabetes (27% v 18%, p < 0.001). After attending rescreening after discharge, those discharged for non-attendance were significantly more likely to have a worsening of DR grade (26% v 8%, p < 0.001).Conclusion: Despite being notified that further investigation (with possible treatment) was required post DRS, many diabetic patients failed to attend for further management of their eye care in DRT. These patients had worse visual outcomes compared to those that attended. Improved patient education and communication are required to mitigate against the consequences of non-attendance.Keywords: maculopathy, follow up, HES, DNA, compliance |
| first_indexed | 2024-04-10T23:17:38Z |
| format | Article |
| id | doaj.art-74432ee9a8f94fa3a2a337cfcc78ace7 |
| institution | Directory Open Access Journal |
| issn | 1177-5483 |
| language | English |
| last_indexed | 2024-04-10T23:17:38Z |
| publishDate | 2023-01-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Clinical Ophthalmology |
| spelling | doaj.art-74432ee9a8f94fa3a2a337cfcc78ace72023-01-12T18:03:06ZengDove Medical PressClinical Ophthalmology1177-54832023-01-01Volume 1718319080938The Effect on Patients’ Visual Acuity and Grade, Secondary to Non-Attendance at Treatment Centers, Post Referral from Diabetic RetinaScreen IrelandHarmon JKelly SAcheson RKeegan DMcMahon SKavanagh HO'Toole LJoanne Harmon,1 Stephen Kelly,2 Robert Acheson,1 David Keegan,2 Shane McMahon,1 Helen Kavanagh,2 Louise O’Toole1 1NEC Care, Cork, Ireland; 2Diabetic RetinaScreen, Heath Service Executive, Dublin, IrelandCorrespondence: Louise O’Toole, NEC Care, 55 South Mall (2nd Floor), Cork, T12 RR44, Ireland, Tel +35318858656, Fax +35318858658, Email lotoole@materprivate.ieBackground: Patient non-attendance following referral to hospital is a significant challenge, in particular, for persons with diabetes.Aim: We sought to determine the impact on both visual acuity and the subsequent follow-up retinopathy grade of patients when they fail to attend Diabetic Retinopathy Treatment (DRT) Centers following referral from Diabetic RetinaScreen (DRS).Methods: A retrospective analysis of patients discharged from DRT due to multiple consecutive missed appointments between January 2016 and June 2021. Patients discharged for non-attendance were compared with patients discharged from completed treatment.Results: Of the 24,945 NEC patients referred to DRT, 5900 (24%) and 9345 (37%) were discharged back to DRS due to non-attendance and completed treatment, respectively. Those discharged for non-attendance were younger (60.7 v 63.4, p < 0.001) and had higher proportions of males (67% v 63%, p < 0.001) and people with type 1 diabetes (27% v 18%, p < 0.001). After attending rescreening after discharge, those discharged for non-attendance were significantly more likely to have a worsening of DR grade (26% v 8%, p < 0.001).Conclusion: Despite being notified that further investigation (with possible treatment) was required post DRS, many diabetic patients failed to attend for further management of their eye care in DRT. These patients had worse visual outcomes compared to those that attended. Improved patient education and communication are required to mitigate against the consequences of non-attendance.Keywords: maculopathy, follow up, HES, DNA, compliancehttps://www.dovepress.com/the-effect-on-patients-visual-acuity-and-grade-secondary-to-non-attend-peer-reviewed-fulltext-article-OPTHmaculopathyfollow uphesdnacompliance |
| spellingShingle | Harmon J Kelly S Acheson R Keegan D McMahon S Kavanagh H O'Toole L The Effect on Patients’ Visual Acuity and Grade, Secondary to Non-Attendance at Treatment Centers, Post Referral from Diabetic RetinaScreen Ireland Clinical Ophthalmology maculopathy follow up hes dna compliance |
| title | The Effect on Patients’ Visual Acuity and Grade, Secondary to Non-Attendance at Treatment Centers, Post Referral from Diabetic RetinaScreen Ireland |
| title_full | The Effect on Patients’ Visual Acuity and Grade, Secondary to Non-Attendance at Treatment Centers, Post Referral from Diabetic RetinaScreen Ireland |
| title_fullStr | The Effect on Patients’ Visual Acuity and Grade, Secondary to Non-Attendance at Treatment Centers, Post Referral from Diabetic RetinaScreen Ireland |
| title_full_unstemmed | The Effect on Patients’ Visual Acuity and Grade, Secondary to Non-Attendance at Treatment Centers, Post Referral from Diabetic RetinaScreen Ireland |
| title_short | The Effect on Patients’ Visual Acuity and Grade, Secondary to Non-Attendance at Treatment Centers, Post Referral from Diabetic RetinaScreen Ireland |
| title_sort | effect on patients rsquo visual acuity and grade secondary to non attendance at treatment centers post referral from diabetic retinascreen ireland |
| topic | maculopathy follow up hes dna compliance |
| url | https://www.dovepress.com/the-effect-on-patients-visual-acuity-and-grade-secondary-to-non-attend-peer-reviewed-fulltext-article-OPTH |
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