Abstract
BackgroundDiabetic retinopathy (DR) is the commonest cause of preventable blindness in working age populations, but up to 98% of visual loss secondary to DR can be prevented with early detection and treatment. In 2012, an innovative outreach DR screening model was implemented in remote communities in a state of Australia. The aim of this study was to explore the acceptability of this unique DR screening model to patients, health professionals and other key stakeholders.MethodsThis descriptive qualitative study used semi-structured interviews with patients opportunistically recruited whilst attending DR screening, and purposefully selected health care professionals either working within or impacted by the programme. Interviews were audiotaped, transcribed and analysed using NVIVO. An iterative process of thematic analysis was used following the principles of grounded theory.ResultsInterviews were conducted with fourteen patients with diabetes living in three remote communities and nine health professionals or key stakeholders. Nine key themes emerged during interviews with health professionals, key stakeholders and patients: i) improved patient access to DR screening; ii) efficiency, financial implications and sustainability; iii) quality and safety; iv) multi-disciplinary diabetes care; v) training and education; vi) operational elements of service delivery; vii) communication, information sharing and linkages; viii) coordination and integration of the service and ix) suggested improvements to service delivery.ConclusionsThe Remote Outreach DR Screening Service is highly acceptable to patients and health professionals. Challenges have primarily been encountered in communication and coordination of the service and further development in these areas could improve the programme’s impact and sustainability in remote communities. The service is applicable to other remote communities nationally and potentially internationally.
Highlights
Diabetic retinopathy (DR) is the commonest cause of preventable blindness in working age populations, but up to 98% of visual loss secondary to DR can be prevented with early detection and treatment
Patient’s General practitioner (GP) to arrange ophthalmology referral the study, focusing on the acceptability of the outreach screening programme to patients, health care providers and other stakeholders and investigates the extent to which the model aligns with components common to effective rural remote DR screening models [12]
Interview participants Health professionals and key stakeholders Six health professionals participating in the screening programme and three key stakeholders anticipated to be impacted by the implementation of the service were interviewed (Table 1)
Summary
Diabetic retinopathy (DR) is the commonest cause of preventable blindness in working age populations, but up to 98% of visual loss secondary to DR can be prevented with early detection and treatment. Indigenous peoples are at risk, with the incidence of blindness six times higher in Indigenous than non-Indigenous Australians [3, 4] This is despite evidence that early detection and timely treatment, can prevent up to 98% of visual loss secondary to DR [5]. Less than 50% of Australian and American patients with diabetes receive appropriate screening, with rural and remote communities with poor access to ophthalmology services at risk [6,7,8,9]. As the number of people with diabetes continues to increase relentlessly worldwide, lack of effective
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