Patients may understand that diabetes can lead to eye disease, and they may receive a recommendation for screening for diabetic retinopathy—but that doesn’t mean they’ll get screened. Researchers from Harbor-UCLA Medical Center surveyed 101 patients with diabetes and 44 providers and staffers at a clinic where annual screening rates for diabetic retinopathy were low. They found that 93% of patients understood the potential risk, but only 55% were getting screened.
The study goal, however, wasn’t to measure understanding of risk but to find out what patients considered barriers to screening and whether health care providers (HCPs) understood those barriers. And the researchers found a gap between the 2 groups.
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Patients were mostly low-income Hispanics and African Americans. The survey asked participants to rate any given barrier that would delay or prevent getting screened. Health care providers and staff were asked to rate the importance of addressing the barriers.
Most of the patients (26%) reported at least 1 barrier to screening, most commonly depression (22%) and financial problems (26%); others reported language issues, lack of transportation, and lack of time.
When surveying HCPs, though, the researchers found “markedly divergent perceptions” between the 2 groups. For instance, only small numbers of patients said transportation, language issues, denial, fear, or cultural beliefs were barriers—yet most HCPs and staff thought those were “very” or “extremely important.”
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By contrast, the barriers the patients did think were important—financial burdens and depression—were rated as less important than other barriers by the HCPs and staff.
The differences in opinions suggest “a lack of high-quality patient-provider communication,” the researchers say. They suggest that more effective patient education as well as heightened awareness of depression and its impact are key to getting more patients screened.