Key result
Provider discussions identify referral processes, patient barriers, and clinic factors influencing diabetic eye screening.
Why the study?
Comprehensive eye exams are recommended at least every 2 years for people with diabetes, but screening rates remain suboptimal.
Qualitative discussion groups identified patient-level and system-level barriers to diabetic eye screening, which can inform strategies to improve screening rates.
Provider insights reveal barriers to diabetic eye screening; hypothesis-generating for targeted interventions before practice change.
Introduction/Objectives: Comprehensive eye exams are recommended at least every 2 years for people with diabetes for early identification and treatment of diabetic eye disease, but screening rates remain suboptimal. Our objective was to qualitatively assess barriers and facilitators to completing recommended eye exam screening for patients with diabetes among providers and practice staff. Methods: As part of a larger initiative, we conducted discussion groups with healthcare providers and practice staff to evaluate factors related to referral and screening for diabetic eye disease at 2 sites, a safety-net healthcare system and a specialty clinic. Discussions were audio-recorded and transcribed. Combined inductive, deductive thematic content analysis was conducted, applying the Practical Robust Implementation and Sustainability Model to organize themes and subthemes. Results: Two discussion groups with 28 participants were conducted in August 2023. Themes included existing processes for referrals, scheduling, and tracking; patient-level determinants including transportation and financial barriers and other competing demands to receiving recommended eye screening; clinic or system-related factors, and considerations for process improvement for eye exam referrals and appointments. Conclusions: These findings can be applied to determine the most effective strategies to improve the rates of recommended eye exam referral and screening rates in people with diabetes.
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Presley et al. (2024) studied Diabetes (n=28). Contextual factors influencing screening for diabetic eye disease was evaluated on Barriers and facilitators to completing recommended eye exam screening. Discussion groups with 28 healthcare providers and staff identified key themes influencing diabetic eye screening, including referral processes, patient barriers, and clinic-related factors.
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