Knowledge Of Diabetic Retinopathy Research Articles

Diabetic retinopathy: Knowledge, awareness, and practices in primary-care centers in the Kingdom of Bahrain.

With the growing incidence of diabetic-related complications such as retinopathy and the well-understood role of screening and telemedicine around the world in preventing and managing this potentially blinding disease, there comes the importance of awareness toward this silent eye condition. Awareness ideally should be raised both from the patients' and physicians' perspectives. This study aims to assess the awareness of primary care physicians (PCPs) towards diabetic retinopathy (DR) and its management. A survey considering professional background, knowledge, and practices was distributed electronically to all PCPs in the Kingdom of Bahrain and analyzed using SPSS Vs 21. A total of 83 physicians completed the survey; 81.9% were female and 96.4% were Bahraini. More than 60% of them accurately knew screening guidelines for type 1 and 2 DR. Of the total, 72.5% would refer patients to the ophthalmologist even if asymptomatic, and 97.6% correctly stated that a dilated eye exam is the method of choice most efficient for assessing DR. Nearly 60% knew about the current treatment modalities for DR and 91.3% knew about the presence of a national screening program in the Kingdom. The overall knowledge of DR was good with some potential gaps in information about screening. PCPs could benefit from regular refresher courses for more precise practices on screening and referral of retinopathy.

Investigation of the reasons for delayed presentation in proliferative diabetic retinopathy patients.

To investigate reasons for delayed presentation in patients with proliferative diabetic retinopathy (PDR). A questionnaire was designed to investigate consecutive PDR patients with delayed presentation who visited our center between January 2021 and December 2021. The questionnaire was divided into four sections: knowledge regarding diabetic retinopathy (DR), attitude toward DR treatment, difficulties adhering to follow-up plans, and medical care. The systemic disease status and severity of DR were recorded. Logistic analysis was undertaken to investigate DR treatment refusal and delay factors. A total of 157 patients were included in this study, with an average age of 50.0 ± 11.6 years. The median glycated hemoglobin level (HbA1c) was 7.8% (IQR 2.5%). Among the 157 eyes, most required vitrectomy intervention (144, 91.7%); 17 developed neovascular glaucoma (NVG), while only 13 required additional photocoagulation. Among the 36 patients with undiagnosed DM, the reason for delayed DR presentation was a lack of awareness of DM status among these patients (36 cases, 100.0%). Most of the patients with a known history of DM exhibited inadequate DR knowledge (29, 24.0%), believed their good visual acuity did not require DR screening (98, 81.0%), and had poorly controlled diabetes (113, 93.3%). Factors related to refusing DR treatment were patients with an inability to receive regular diabetes treatment in internal medicine clinics (OR 6.78, 95% CI 1.73-26.59, p = 0.006), patients who could not tolerate discomfort during ophthalmic examination and treatment (OR 15.15, 95% CI 2.70-83.33, p<0.001), and patients who did not have any retinal abnormalities detected and were not informed about the need for regular screening (OR 2.05, 95% CI 1.36-3.09, p<0.001). This study investigated the factors contributing to delayed presentation among patients with PDR. Many individuals in the delayed population were found to have undiagnosed DM. Among patients already aware of their DM status, reasons for delay included insufficient knowledge about DR, negative attitudes toward screening and treatment, and difficulties seeking medical care in real-life situations. Furthermore, there needed to be more improvements in the detection, treatment, and follow-up of DR by internal medicine practitioners and ophthalmologists.

Present and future screening programs for diabetic retinopathy: a narrative review.

Diabetes is a prevalent global concern, with an estimated 12% of the global adult population affected by 2045. Diabetic retinopathy (DR), a sight-threatening complication, has spurred diverse screening approaches worldwide due to advances in DR knowledge, rapid technological developments in retinal imaging and variations in healthcare resources.Many high income countries have fully implemented or are on the verge of completing a national Diabetic Eye Screening Programme (DESP). Although there have been some improvements in DR screening in Africa, Asia, and American countries further progress is needed. In low-income countries, only one out of 29, partially implemented a DESP, while 21 out of 50 lower-middle-income countries have started the DR policy cycle. Among upper-middle-income countries, a third of 59 nations have advanced in DR agenda-setting, with five having a comprehensive national DESP and 11 in the early stages of implementation.Many nations use 2-4 fields fundus images, proven effective with 80-98% sensitivity and 86-100% specificity compared to the traditional seven-field evaluation for DR. A cell phone based screening with a hand held retinal camera presents a potential low-cost alternative as imaging device. While this method in low-resource settings may not entirely match the sensitivity and specificity of seven-field stereoscopic photography, positive outcomes are observed.Individualized DR screening intervals are the standard in many high-resource nations. In countries that lacks a national DESP and resources, screening are more sporadic, i.e. screening intervals are not evidence-based and often less frequently, which can lead to late recognition of treatment required DR.The rising global prevalence of DR poses an economic challenge to nationwide screening programs AI-algorithms have showed high sensitivity and specificity for detection of DR and could provide a promising solution for the future screening burden.In summary, this narrative review enlightens on the epidemiology of DR and the necessity for effective DR screening programs. Worldwide evolution in existing approaches for DR screening has showed promising results but has also revealed limitations. Technological advancements, such as handheld imaging devices, tele ophthalmology and artificial intelligence enhance cost-effectiveness, but also the accessibility of DR screening in countries with low resources or where distance to or a shortage of ophthalmologists exists.

Implementation of Diabetic Retinopathy Screening in Adult Patients With Type 2 Diabetes in a Primary Care Setting.

Diabetic retinopathy (DR) is a microvascular complication of type 2 diabetes and the leading cause of blindness globally. Although diabetes-related eye exams are widely recognized as an effective method for early detection of DR, which can help to prevent eventual vision loss, adherence to screening exams in the United States is suboptimal. This article describes a quality improvement project to increase DR screening rates and increase knowledge and awareness of DR in adults with type 2 diabetes in a primary care setting using mobile DR screening units. This project addressed gaps of care and demonstrated that primary care settings can increase access to DR screening through a patient-centered process and thereby help to prevent irreversible outcomes of DR and improve quality of life.

Knowledge of Diabetic Retinopathy among Primary Care Nurses Performing Fundus Photography and Agreement with Ophthalmologists on Screening.

Diabetic retinopathy (DR) is one of the complications of diabetes mellitus (DM), with macular oedema being one of the leading causes of avoidable blindness among individuals with DM worldwide. Fundus screening is the only method for early detection and treatment. High-quality training programmes for professionals performing primary care screening are essential to produce high-quality images that facilitate accurate lesion identification. This is a two-phase observational, descriptive, and cross-sectional study. The first phase analysed DR knowledge in a sample of nurses. The second phase explored agreement on DR screening between referral ophthalmologists in image assessment (gold standard) and a small group of nurses involved in the previous phase. In phase 1, the agreement rate for screening results was 90%. In phase 2, the overall raw agreement on the screening of fundus photography results between nurses and ophthalmologists was 75% (Cohen's kappa = 0.477; p < 0.001). Agreement on screening with ophthalmologists was moderate, suggesting that implementing a specific training programme for nurse-led imaging screening would help develop this competence among nurses, ensuring a good level of agreement and patient safety and adding value for users, and also for the sustainability of the healthcare system. This study was not registered.

Awareness of diabectic retinopathy among diabetics in urban population of Hyderabad, South India

Diabetes Mellitus (DM) is a significant public health burden in India. Focus on Diabetes and its complications is important to prevent mortality and morbidity due to this disease. Lack of awareness is one of the main barrier for detection of DM and its complications. Diabetic retinopathy (DR) is one of the most common complication of DM which causes of blindness and visual impairment. The purpose of this study was to assess knowledge and attitude of diabetic patients towards eye care and DR in urban south Indian population.Cross-sectional study was done on 537 patients with Type 2 Diabetes Mellitus. All patients underwent complete ocular examination including visual acuity, anterior segment and fundus examination using slit-lamp biomicroscope by attending Ophthalmologist. They were administered questionnaire to test their knowledge and attitude. Their answers were documented. Statistical analysis was done using SPSS software (IBM).Out of 537 patients (50.9%) patients knew that there was relationship between Diabetes and Retinopathy while (49.1%) patients were not aware of. 60.4% of patients were of the opinion that there was no need of regular screening if vision in both eyes are good and 39.6% of patients were of the opinion that they should undergo a routine ophthalmology screening every year despite of good vision in both the eyes. 69.6% of patients said that good control of DM might prevent DR. The level of knowledge of DR was found to be significantly associated with patients’ educational level (p=0.038). Patients with relatively higher educational level were more aware of DR occurring as a consequence of diabetes. Patients with longer duration of Diabetes had more knowledge on DR (p=0.001).In our study there was an association between educational qualification and knowledge regarding Diabetic retinopathy. (p value=0.04). This stresses on the importance of health education amongst rural and illiterate population.

To determine knowledge, attitude, and practice regarding diabetic retinopathy among diabetic patients in a multispecialty hospital: A cross-sectional study

Context: Diabetic retinopathy (DR) is an important complication of diabetes mellitus (DM). DR accounts for 4.8% of the cases of blindness throughout the world. Aims: To assess the patients' awareness about DR and their attitude and practice patterns in a tertiary care system in urban Maharashtra. Subjects and Methods: A cross-sectional study was conducted in a tertiary care hospital, Pune, Maharashtra from March 2019 to April 2020 after approval from institutional review board. Patients older than 18 years and who were diagnosed with type II DM were included. Data were entered into Excel and analyzed using the SPSS software version 20. Results: Only 28% of diabetic patients had good knowledge of DR, 82.5% were found to have positive attitude toward DR screening, and 27% had scored good in the practice score category. A significant association was found between DR knowledge with level of education (P ≤ 0.001). Conclusions: Better knowledge of DR influences a positive practice patterns in patients with diabetes. Onus lies on the healthcare professionals, particularly physicians as they are the first point of contact.

Factors associated with diabetic retinopathy screening and regular eye checkup practice among diabetic patients attending Felege Hiwot Specialized Hospital.

To identify associated factors of diabetic retinopathy (DR) screening and ey e check-up practice among diabetes mellitus (DM) patients attending Felege Hiwot Specialized Hospital. An institution-based cross-sectional study was applied from October 4, 2019 to January 12, 2020 at Felege Hiwot Specialized Hospital. A systematic random sampling technique was used to recruit participants and an interviewer-administered questionnaire was employed to collect the data. The collected data were entered into Epi Info version 7 and transposed to SPSS version 24 for statistical analysis. Descriptive statistics were executed and associated factors were identified using binary logistic regression. The strength of association between the independent and the outcome variable was determined using an adjusted odds ratio (AOR) with 95% confidence interval (CI). Four hundred and six participants partake with a response rate of 95.7% and a mean age of 47±11.5y. The magnitude of DR screening was 308 (75.9%, 95%CI: 71.5%, 79.8%). Higher educational level (AOR=3.25; 95%CI: 1.40, 8.78), good knowledge of DR (AOR=2.50; 95%CI: 1.55, 4.46), and family history of DM (AOR=2.15; 95%CI: 1.41, 3.85) were significantly associated with DR screening. On the other side, rural residence [AOR=3.11 (1.89, 5.02)] and undesirable attitudes toward DR [AOR=5.65 (3.14, 8.76)] were significantly associated with poor regular eye checkup practice. Most of the participants are screened for DR. Higher education, family history, and good knowledge are associated with DR screening. In addition, rural residence and undesirable attitudes toward DR are associated with regular eye checkup practice.

Experience of patients with diabetic retinopathy: A qualitative study.

To understand the status quo and needs of self-management of patients with diabetic retinopathy (DR) and to provide a reference for formulating management programs that meet the needs of these patients. A qualitative interview study. Semi-structured, in-depth interviews were conducted between November and December 2021. A purposive sample of 15 patients with DR who were hospitalized in the Retinal Department of Eye Hospital was recruited. Colaizzi's analysis was used to organize and analyse the interview data. This study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. The experience of patients with DR can be summarized into four themes: (1) lack of DR knowledge, (2) low quality of life, (3) poor self-management behaviour and (4) seek for support from many aspects. Patients with DR lack disease knowledge and have poor self-management abilities and adherence. Medical staff should provide personalized care according to the patient's self-management status and needs, promote the establishment of self-management behaviours and prevent and delay disease progression. This study helps assist medical staff in the early management of patients with DR and provides a reference for the construction of prevention programs for patients.

Impact of diabetic retinopathy awareness training on community health workers' knowledge and referral practices in Fiji: a qualitative study.

Community health workers (CHWs) are effective in raising awareness about diabetes mellitus and diabetic retinopathy (DR). In Fiji, CHWs were trained in a 1-day diabetic retinopathy (DR) awareness to provide communities with adequate basic knowledge about diabetes and DR to improve awareness and enhance referrals for DR screening and treatment. This study aimed to explore the impact of this training on CHWs' knowledge of DR and their referral practices related to DR screening in Fiji 2 years post-training. This qualitative study was conducted in 2021 across three out of the four administrative divisions of Fiji, namely the Western, Northern and Central divisions. A total of 14 CHWs from the three divisions of Fiji participated in this study. All participants had attended a 1-day DR awareness training 2 years before this study. Participants were chosen purposively and were invited to participate in focus group discussion (FGD). The FGDs were audio-recorded and transcribed verbatim, and thematic analysis was conducted to identify and classify recurrent themes. CHWs indicated that their knowledge about both diabetes and DR improved significantly after the training. This boosted their confidence in talking about these issues and providing clarity regarding referrals for DR screening in their respective communities. Consequently, they have referred a significantly higher number of people for screening both in outreach and to health facilities. Challenges in referral included poverty, high transportation cost and social support needs, which hindered screening. Further, although CHWs felt some degree of integration within the health system, they thought more was needed. Investing in scalable models such as training CHWs is an important first step in tackling diabetes and DR in communities, particularly at the grassroots level in low-resource settings by increasing the community's knowledge of DR and improving access to screening, diagnosis and treatment.

Assessment of Knowledge, Attitude, and Practice Regarding Diabetic Retinopathy in an Urban Population in Northeast China.

ObjectiveThis study aimed to assess the knowledge, attitude, and practice (KAP) of diabetic subjects with diabetic retinopathy (DR) and those without DR (NDR) in an urban community in Northeast China, as well as their risk factors in subjects with DR and NDR.MethodsA community-based survey involving 1,662 subjects was conducted in Fushun, China, between July 2012 and May 2013. The subjects included diabetics with DR (n = 783) and those NDR (n = 879), and questionnaires were completed to collect information about their sociodemographic and healthcare characteristics. A Chi-square test and multiple logistic analyses were performed to analyze the data.ResultsAmong the DR group, 21.88% had a good knowledge of DR, 94.15% had a positive attitude, and 68.07% followed good practice, whereas 20.98% of the NDR group had a good knowledge of DR, 94.18% had a positive attitude, and 66.92% followed good practice. There was no significant difference in the KAP of the two groups of subjects. In the NDR group, a good level of knowledge was associated with a high-level of education (OR = 0.1, 0.2; p < 0.05), a good attitude was associated with retirement (OR = 0.2; p < 0.05), and good practice was associated with being female, having a high-level of education, and the type of treatment (OR = 0.5, 0.4, 2.3, 3.1; p < 0.05). In the DR group, good practice was associated with older age and retirement (OR = 0.6, 0.4; p < 0.05).ConclusionsThere was no significant difference between the DR and NDR subjects in the overall levels of KAP, but both groups showed a poor level of knowledge. Age, gender, education, occupation, and type of treatment were the main factors associated with the KAP scores, more risk factors in the NDR group than in the DR group. There is an urgent need for coordinated educational campaigns with a prioritized focus on the northeast region of China, especially NDR group.

Awareness of diabetic retinopathy among patients with type-2 diabetes mellitus in Abha, Saudi Arabia: A survey-based research study.

ABSTRACTContext:Diabetic retinopathy (DR) is an avoidable retinal disorder affecting the retina and is deemed the most common microvascular complication of diabetes mellitus (DM).Aims:This study aimed to estimate the awareness and attitude of type 2 diabetic patients toward DR.Methods and Materials:A study questionnaire was distributed among Saudi patients with type 2 DM who visited primary health care at Abha, Saudi Arabia, after obtaining an ethical approval. It was a modified questionnaire and included basic demographic characteristics of the patients, general knowledge and awareness of DM and DR, and their practices toward eye examination.Statistical Analysis Used:Data analysis was performed using SPSS software. Chi-square and z-proportionality tests were applied where appropriate.Results:A total of 381 patients with DM responded to our survey; 36% of them had DM for five years or less. Notably, 93.5% of participants knew that diabetes can cause eye disease but only 63.3% agreed that regular eye examination for diabetic patients is necessary, with a significant difference of DM duration (p = 0.01). A total of 217 (57%) patients thought that there is no need to visit an ophthalmologist if diabetes is under control. However, 74.5% believed that patients with type 2 DM should go for an eye examination once diagnosed, with a significant difference between disease duration subgroups (p = 0.006).Conclusion:The current study demonstrated high levels of awareness regarding the effect of DM on the eye and importance of early eye assessment. However, we need to improve the patients’ awareness to the value of regular eye checking and standard practices.

Knowledge outcome of visual-simulation-based over print-based diabetic retinopathy health education amongst the Omani community residing in Al Batinah, Oman

Background: Evidence-based contextual diabetic retinopathy (DR) related health promotion tools are essential in improving patient compliance and reducing the condition-related burden within the community.Aim: This study compares DR related knowledge impact amongst the population following the traditional print based health education over the developed visual simulations.Setting: This prospective cross-sectional study was conducted within a province in Oman over the duration of one year.Methods: One hundred and thirty-six (50.6%) participants were provided with print-based and 133 (49.4%) with visual-simulation-based DR related health promotional intervention. A questionnaire and model responses were designed and validated to assess the knowledge of the participants about DR.Results: The improvement in DR related knowledge scores was slightly higher in the print-based version (17.88%) compared to the visual-simulation-based (15.77%) health education. However, the Mann Whitney U test indicated a statistically insignificant (U = 8446.5, p = 0.348) difference in change in the knowledge scores between these groups following the provision of DR related health education either with the print-based or visual-simulation-based version.Conclusion: Print-based, as well as visual-simulation-based health educational interventions are effective in improving DR related knowledge. Although there is not enough evidence to support the visual-simulation method over the print-based DR health education, observing the similar positive impact upon the DR knowledge level with the latter method, this study suggests the use of these contextual visual simulations as an alternative strategy of DR health education. There is a need to develop evaluation strategies for the health promotional tools. The evidence-based health promotional tools are recommended to be integrated within the eye health system.

Knowledge attitude practice study of diabetic retinopathy

Background: Diabetic retinopathy (DR) is an important cause of visual impairment. It is preventable with proper screening and treatment of diabetes. Therefore, it is necessary to assess awareness of the disease in the population and educate them. Our study aimed to assess the knowledge, attitude and practices regarding diabetes and DR in India.Methods: We conducted a knowledge, attitude, and practice study of 1152 participants belonging to various economic backgrounds across India, using a validated questionnaire from Shri C. H. Nagri Eye Institute, Ahmedabad. We divided the study population into diabetics and non-diabetics. Statistical analysis was done using SPSS version 20.Results: Out of 1152, 121 (10.5%) were diabetics and 1031 (89.5%) were nondiabetics. Mean age of diabetics (55.71) was higher than non-diabetics (37.55) (p&lt;0.001). Only 34% of non-diabetics and 55% of diabetics knew about DR. There was a positive co-relation between knowledge of diabetes (r=0.262, p&lt;0.001) and DR (r=0.096, p=0.031) with the level of education. Only 20% admitted that diabetics were at a higher risk for eye problems. A significant portion of participants (40%) said they were never counselled for DR and 54% never had a fundus examination.Conclusions: The There is a clear lack of knowledge regarding diabetes and diabetic retinopathy. An alarming percentage of patients were never told about the complications and need for regular fundus examinations. There is an urgent need to increase its awareness. A collaborative approach of general-practitioners, ophthalmologists, diabetologist as well as health-policy makers is required to provide needs-based, context-specific comprehensive diabetic care in India.

Health education improves referral compliance of persons with probable Diabetic Retinopathy: A randomized controlled trial.

Lack of awareness about Diabetic Retinopathy (DR) is the most commonly cited reason why many persons with type 2 diabetes are non-compliant with referral instruction to undergo retinal screening. The purpose of this study was to evaluate the efficacy of a culturally, geographically and socially appropriate, locally adapted five-month-long health education on referral compliance of participants. A prospective randomized, open-label parallel group study was conducted on persons with type 2 diabetes who underwent basic eye screening at a diabetes hospital between September 2017 and August 2018. Participants who were noncompliant with referral instruction to visit a hospital for advanced DR management were randomly divided into health education intervention group (n = 143) and control group (n = 156). Both groups received information regarding DR and referral instruction at the diabetes hospital. The intervention group was provided personalized education followed by telephonic reminders. The primary endpoint was 'increase in referral compliance' and the secondary endpoint was 'increase in knowledge of DR'. Multivariate logistic regression model was used to identify significant predictors of compliance to referral. A total of nine participants dropped and 290 completed the post intervention survey. The compliance rate in intervention group was found to be significantly higher than the control group (64.3% vs 28.2%; OR 4.73; 95% CI 2.87-7.79; p<0.001). Participants in the intervention group acquired better knowledge on DR (p<0.05). Apart from intervention, referral compliance rate was also found to be significantly associated with participants' self-perception of vision problem (OR 2.02; 95% CI 1.02-4.01; p = 0.045) and participants' income (OR 1.24; 95% CI 1.06-1.44; p = 0.008). Our results suggest that intensive health education on DR should be integrated with diabetes education as it may result in significantly improved referral compliance. Outcomes may be sustainable if interventions are institutionalized at referral point. Clinical Trials.gov (Registration # NCT03658980); https://clinicaltrials.gov/ct2/show/NCT03658980.

Knowledge and practices regarding diabetic retinopathy among diabetic patients registered in a chronic disease management system in eastern China.

To investigate the knowledge and practices regarding diabetic retinopathy (DR) among diabetic patients included in a community-based primary health system (CBPHS) in China. Diabetic patients aged 18 years and above registered in the CBPHS in Yueqing city, Zhejiang province were recruited. Information obtained by questionnaire included: demographic and socioeconomic status, knowledge about DR, and ocular and medical history. The primary outcome was whether the participant knew that DM can affect the eyes, defined according to the question: "Do you know diabetes mellitus (DM) can affect eyes? (yes or no)". A knowledge score was calculated based on the responses to seven questions, with 1 point awarded for a correct response and 0 points for an incorrect or uncertain answer. A total of 1972 diabetic patients were included in the study with an average age of 65.2±10.8 years, 45.7% were male. One thousand two hundred and nineteen patients (61.8%) knew that DM can affect the eyes. Significant differences in age, education, income status, insurance covering eye care, fasting blood glucose, duration of DM, history of hypertension existed between subjects who knew and those who did not know that DM can affect the eyes (P<0.05 for all). The proportion of correct answers to the DR knowledge questions ranged from 33.3% to 61.8%, with an average score of 3.65±2.47. In the multiple regression analysis, the knowledge score was significantly associated with age, education, income, history of hypertension, duration of DM, being told that regular examinations should be performed and concern about vision loss (P <0.01 for all). The knowledge toward DR among DM patients were still low within the chronic disease management system in eastern China. Routine ophthalmic screening, health care promotions, and educational programs should be emphasized and implemented for better DR prevention and management.

Baseline Diabetes Knowledge Assessment Amongst Adults With Type 1 and Type 2 Diabetes Receiving Eye Care at a Tertiary Ophthalmic Centre in Canada

ObjectivesThe aim of this work was to assess the current state of baseline knowledge of diabetes and diabetic retinopathy (DR) in new patients referred to a tertiary retina service from their primary eye care provider. MethodsThis single-centre, prospective, observational study included patients presenting to the retina clinic at the Hamilton Regional Eye Institute, a major tertiary referral centre, for their initial consultation for diabetes- or DR-associated complications. Upon recruitment into the study, patients were asked to complete a 35-item questionnaire regarding diabetes and associated complications. All data were coded and analyzed using statistical software. ResultsA total of 98 patients participated in the study, which included 50 men and 48 women. Seventy-eight patients (79.6%) were Caucasian. We found that 56.1% (n=55) of the patients did not know the meaning of “HbA1C” (glycated hemoglobin) and only 26.5% of patients sampled were aware of their DR status. Bivariate analysis revealed that patients who had postsecondary education (p<0.001) or those who had education on complications of diabetes (p<0.05) were more likely to know their DR status. More importantly, it was found that 56.1% of patients expressed interest in a future diabetes seminar. ConclusionsIt is evident that a significant proportion of patients do not have adequate knowledge of diabetes or DR, and this is related to their level of education and lack of being taught about diabetes complications. Our findings may guide prevention initiatives by primary eye care providers and promote increased awareness about diabetes and DR for prevention of disease complications, including blindness.

Impact of mobile health in diabetic retinopathy awareness and eye care behavior among Indigenous women.

Diabetes is increasingly widespread among Indigenous people, and diabetic retinopathy (DR) is a diabetes eye complication and a common cause of vision loss among adults in Canada. Indigenous women have a high risk of diabetes which increases their risk for DR. This study explored utilizing mobile health (mHealth) via text messages to provide DR awareness and improve diabetic-eye care behavior. This study identified the changes in DR awareness and eye care behavior due to a mHealth education intervention among Indigenous women with or at risk of diabetes. A pre-post study which adopted an embedded concurrent mixed methods approach guided by self-determination theory and the medicine wheel. Study participants were First Nations and Métis women living with or at risk of diabetes in Saskatoon, Canada. Data was collected via sharing circles and a DR knowledge, attitude, and practice survey. Pre-intervention participants' baseline information on DR knowledge and behavior were obtained from participants. After that, participants received daily text messages on diabetes-eye related information for 12 weeks. Post-intervention, the impact of the mHealth intervention on DR awareness and eye care behavior was assessed. Following the intervention, the DR knowledge, attitude, and practice scores significantly improved. Individuals living with diabetes had increased DR attitude and practice post-scores compared to those at risk of diabetes. Older women had a lower pre-post change in practice scores compared to younger women. The mHealth intervention provided a holistic approach to support diabetes-eye care and empowered the study participants to eat healthily, take medication as prescribed, and have regular medical and eye check-ups. The mHealth education intervention increased DR awareness and fostered a change in diabetes-eye care behavior. Health information via text messaging can motivate, provide support, and empower individuals as well as prevent and manage chronic conditions and reduce the risk of complications.

Awareness and knowledge of diabetic retinopathy and associated factors in Goa: A hospital-based cross-sectional study.

Purpose:To assess the awareness and knowledge about diabetic retinopathy (DR) and associated factors among patients visiting the tertiary health center in Goa.Methods:A cross-sectional descriptive study was conducted using a standard predesigned and pretested closed-ended structured questionnaire to assess the awareness, knowledge, attitude and practice about DR among patients visiting a tertiary health center.Results:Three hundred and fifty-eight subjects participated in the study. Only 125 (34.9% [95% CI: 30.0–40.1]) subjects were aware of DR and 122 (34.1% [95% CI: 29.2–39.2]) had adequate knowledge about DR. Awareness and knowledge of DR were significantly high among the subjects who completed college level of education (66.7%, OR = 2.78; 95% CI: 1.73–4.48, P < 0.001 and 55.9%, OR = 3.92; 95% CI: 2.41–6.38, P < 0.001) and who spoke English (52.5%, OR = 3.37; 95% CI: 2.14–5.30, P < 0.001 and 50.4%, OR = 3.26; 95% CI: 2.07–5.14, P < 0.001). Christians reported better knowledge about DR compared to other religions (48.8%, OR = 2.27; 95% CI: 1.38–3.75, P = 0.005). Negative association was noted between the knowledge of DR and presence of diabetes (29.4%, OR = 0.64; 95% CI: 0.41–0.99, P = 0.048). The practice pattern was strongly associated (OR = 7.47; 95% CI: 4.51–12.38, P < 0.001) with the knowledge of DR. Attitude was not influenced by any of the factors.Conclusion:We found that awareness and knowledge about DR were unsatisfactory; literacy contributed significantly toward it. These findings also suggest that there is an immediate need to enhance the awareness and knowledge of diabetic eye diseases in order to reduce the burden of visual impairment.

Process of adaptation, development and assessment of acceptability of a health educational intervention to improve referral uptake by people with diabetes in Sri Lanka

BackgroundOne major barrier to uptake of diabetic retinopathy (DR) services is lack of knowledge and awareness of DR among the people with diabetes (PwDM). Targeted health education (HE) can be a key element in improving the uptake of eye care services. Such interventions are lacking in Sri Lanka.MethodsA local context specific HE intervention (HEI) was developed by adopting available resources and incorporating views from PwDM and key stakeholders. Four sessions of participatory workshops with PwDM (20 Sinhala and 13 Tamil speaking) and two stage 12 stakeholder interviews were conducted to both develop and pre-test the material. The products were a video and a leaflet, delivered at a medical clinic to a sample of 45 PwDM identified as having DR. Semi-structured interviews were conducted after 4 weeks, to evaluate the acceptability and comprehension of the HEI. Additionally, nine interviews were conducted with clinical providers to explore process issues related to delivery of the HEI. Data analysis was conducted using thematic analysis.ResultsThe lack of knowledge and awareness on DR, and of the importance of regular DR screening and follow up, combined with poor information on referral pathways were key elements identified from the workshops with PwDM. The stakeholders prioritised the importance of using simple language, and the need for emphasis on improving understanding about the asymptomatic phase of DR. The overall acceptability of the HEI material was satisfactory, although there was some difficulty with interpretation of medical images. Overall, although PwDM liked the ideas of the video, the leaflet was seen as a more practical option, given the busy clinic environment. The key issue was both formats required interaction with the provider, in order to support understanding of the messages.ConclusionsThe process of adapting HE material is not simply translation into the appropriate language. Instead, a tailored approach in a country, context and particular health services setting is needed. This study illustrates the value of using a participatory approach and involving PwDM and stakeholders in the adaptation and pilot testing of a HEI to improve uptake of screening for DR in the context of Sri Lanka.