Diabetic retinopathy (DR) is a serious issue for diabetics. In fact, it’s the leading cause of blindness in American adults of working age. But there’s a real problem: early detection is crucial, yet the average wait time for a DR screening at an optometrist or ophthalmologist office has been around 8+ months.

Even more troubling, not everyone needing a DR screening always gets a DR screening.

So what if primary care physicians could be the solution to this eye issue?

Researchers attempted to answer that very question by taking a teleretinal DR screening program to 5 safety net clinics in the Los Angeles County Department of Health Services network.

Some of these clinic’s medical assistants and nurses were trained to use fundus photography. Those images were then sent to optometrists to determine whether or not the patient had diabetic retinopathy and what appointments/referrals were necessary.

These primary care screens went on for just over two years so researchers could fully understand two key factors:

  • Could primary care based DR screening affect overall screening rates?
  • Could primary care based DR screening affect the wait times for screenings?

In total 21,222 patients were screened. Here are the main findings:

  1. Overall Screening Rate Increase

The annual rate of screening for diabetic retinopathy jumped up by 16.3%. Before the program was implemented, only 40.6% of patients had been screened. That number shot up to 56.9% with this primary care based program.

Since nearly 20% of the screened patients moved on to an eye care specialist with a referral to treat or monitor their diabetic retinopathy – this program was catching DR sooner than it would have been caught before.

  1. Wait Time Reduction

But the real kicker came in the form of a decrease: an 89.2% DR screening wait time reduction. What used to take an average of 158 days only took 17 days with the primary care screening program.

When you’re talking about discovering the leading cause of blindness in American adults, getting those exams that much faster could make a significant impact on U.S. eyesight.

  1. Unnecessary Referral Reduction

Not to mention, this screening showed that unnecessary appointments to eye care providers could be dramatically lowered.

Nearly 15,000 of the 21,000 patients who were screened in this study did not need a referral to an eye care professional. Their eyes were fine, and the patients got to know that before going through the long (and sometimes expensive) specialist process.

Researchers concluded that these programs could have the “potential to maximize access and efficiency.” There is promise for programs like these to make an impact on diabetic retinopathy in the future – especially among safety net-type clinics, where patients may not have all the resources to benefit from traditional specialist-only screenings.

If you are a diabetic, make sure you are receiving a DB screenings through your doctor annually.

 

 

Sources:

http://www.jwatch.org/fw112701/2017/03/28/diabetic-retinopathy-screening-primary-care-based

http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2612116

http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2612113