Geographic Information Systems Pinpoint Barriers to Eye Care for Diabetic Retinopathy

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Researchers conducted a cross-sectional study in 5 primary care clinics in North Carolina.
Researchers conducted a cross-sectional study in 5 primary care clinics in North Carolina.

HealthDay News — Geographic information systems mapping can visualize geographic access barriers to eye care among patients with diabetes, while telescreening can increase the rate of diabetes retinopathy evaluation, according to 2 studies published online in JAMA Ophthalmology.

Pooja D. Jani, MD, from the University of North Carolina at Chapel Hill, and colleagues used geographic information systems mapping techniques to visualize access barriers to eye care for patients with diabetes in a cross-sectional study conducted in 5 primary care clinics in North Carolina. 

A total of 1787 patients with diabetes received retinal screening photographs with remote expert interpretation to identify diabetic retinopathy. The researchers found that the widest distribution of zip codes was seen at the Greenville site. Ophthalmologists were concentrated around urban centers, while primary care physicians were spread across the state.

In a second study, Jani and colleagues examined retinal telescreening for patients with diabetes in a pre- and postimplementation evaluation. Data were included for 1661 patients at 5 primary care clinics serving rural and underserved populations in North Carolina. The researchers found that the mean rate of diabetic retinopathy screening was 25.6% before implementation of the program, and increased to 40.4% after implementation. Within the study period, 60% of referred patients completed an ophthalmology referral visit. The odds of requiring a referral were increased for older patients, African-American patients, and other racial/ethnic minorities (odds ratios, 1.28, 1.84, and 2.19).

"Retinal telescreening increased the rate of evaluation for [diabetic retinopathy] for patients in rural and underserved settings," the authors of the second study wrote.

Disclosures: One author from both studies disclosed financial ties to Welch Allyn.

References

  1. Jani PD, Forbes L, McDaniel P, et al. Geographic information systems mapping of diabetic retinopathy in an ocular telemedicine network [published online May 18, 2017]. JAMA Ophthalmol. doi:10.1001/jamaophthalmol.2017.1153
  2. Jani PD, Forbes L, Choudhury A, et al. Evaluation of diabetic retinal screening and factors for ophthalmology referral in a telemedicine network [published online May 18, 2017]. JAMA Ophthalmol. doi:10.1001/jamaophthalmol.2017.1150
  3. Ting DSW, Tan GSW. Telemedicine for diabetic retinopathy screening [published online May 18, 2017]. JAMA Ophthalmol. doi:10.1001.jamaophthalmol.2017.1257
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