LBODP048 Barriers To Diabetic Retinopathy Screening In Hospitalized Patients With Diabetes

Abstract

Abstract Diabetic retinopathy (DR) is a leading cause of preventable vision loss in the in the U. S., and DR screening is essential to prevent blindness. Yet minority populations have consistently lower DR screening rates than Non-Hispanic Whites and knowledge about barriers versus facilitators for completion of DR screening in these groups remains scant. Improvement in DR Screening rates in safety net populations has been observed after placing digital retinal cameras in primary care sites to capture images where patients get their basic health care. In this study, we therefore assessed DR screening in patients at time of hospitalization as a possible additional site to capture unscreened patients with diabetes. We identified patient with diabetes admitted for any reason to a safety net hospital to evaluate perceived barriers to DR screening. We performed an anonymous survey in English or Spanish in 156 hospitalized adult patients with diabetes during hospital stays between 10/2019-12/2021, using a convenience sample. Barriers specified in the survey were derived from the literature. The study population had a mean [+SD] age of 50+10.5 years, were predominantly male [72.4%], of low-income [83.7% <$25,000/year] and minority groups [Latinos 79.5% and African American [10.3%]. Diabetes duration was >5years in 63.6% of patients. Reported DR screening rate in the 12 months prior to admission was only 31.4%, despite 97% of patients confirming they were aware that diabetes causes impaired vision and blindness. The main perceived barriers to DR screening identified in the survey were financial [50%], transportation [22%] and depression [17%]. There were no significant differences in the number or nature of perceived barriers in those who reported DR screening vs. those who did not. Surprisingly, the pandemic appeared to have little impact on DR screening rates. Comparison of patients surveyed before (n=96; 10/2019-03/20) and after COVID lockdown (n=60; 08/2020-12/2021), did not show any significant differences in patient demographics, number or nature of perceived barriers, or DR screening rates (32% vs 30%). However, DR screening among patients without a Primary Care Provider (PCP) was considerably lower compared to patients with a PCP, 10% vs 49% (p<0. 001). In summary, this study reveals low prior outpatient DR screening rates in hospitalized patients with diabetes in low-income minorities in a safety-net hospital, and identifies potential remediable barriers associated with this. The results suggest that cost and transport barriers could be addressed by implementation of DR screening during hospitalization in safety net hospitals. These results also emphasize the significance of a having a PCP. We conclude that inpatient DR screening and facilitating PCP-patient connections might lead to improvement in DR screening rates and thus prevent blindness in this segment of the diabetes population. Presentation: No date and time listed