The Effect on Patients' Visual Acuity and Grade, Secondary to Non-Attendance at Treatment Centers, Post Referral from Diabetic RetinaScreen Ireland

Joanne Harmon; Stephen Kelly; Robert Acheson; David Keegan; Shane McMahon; Helen Kavanagh; Louise O'Toole

doi:10.2147/OPTH.S388988

The Effect on Patients' Visual Acuity and Grade, Secondary to Non-Attendance at Treatment Centers, Post Referral from Diabetic RetinaScreen Ireland

Clin Ophthalmol. 2023 Jan 11:17:183-190. doi: 10.2147/OPTH.S388988. eCollection 2023.

Authors

Joanne Harmon¹, Stephen Kelly², Robert Acheson¹, David Keegan², Shane McMahon¹, Helen Kavanagh², Louise O'Toole¹

Affiliations

¹ NEC Care, Cork, Ireland.
² Diabetic RetinaScreen, Heath Service Executive, Dublin, Ireland.

Abstract

Background: 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: DNA; HES; compliance; follow up; maculopathy.