Perceptions of a Teleophthalmology Screening Program for Diabetic Retinopathy in Adults With Type 1 and Type 2 Diabetes in Urban Primary Care Settings

Abstract

ObjectivesTeleophthalmology has improved diabetic retinopathy screening, and should be expanded in urban areas, where most unscreened individuals reside. In this study, we explored facilitators of and barriers to teleophthalmology in primary care settings in Toronto, Canada. MethodsSemistructured interviews were conducted with 7 health-care providers and 7 individuals with diabetes to explore their perspectives of teleophthalmology in urban primary care settings. Interview data were analyzed using interpretive thematic analysis to generate themes. ResultsSix themes were identified. Facilitators included patient-centred implementation, access to teleophthalmology at primary care sites and patients’ trust in their providers’ recommendations. Barriers included patients’ lack of understanding of diabetic retinopathy and the health-care system, providers’ lack of interest and the need to streamline administrative processes. ConclusionsAlthough teleophthalmology was well-received by patients, there was limited interest from primary care providers. Strategies for increasing uptake include increasing primary care providers’ awareness of teleophthalmology’s value in urban centres, improving administrative processes and centralizing patient recruitment.