Targeted eye care education urged for adults with diabetes

Chou CF. Diabetes Care. 2013;doi:10.2337/dc13-1507.

  • September 17, 2013

The utilization of eye care among patients with diabetes requires education targeted at financial barriers and comprehension of ophthalmic implications of their disease, according to researchers.

“In the United States, Medicare covers an annual eye examination for those with diabetes, and most health insurance covers medical eye examination and payment for eye diseases such as diabetic retinopathy, cataract, and glaucoma. However, 25% to 47% of those with diabetes do not have yearly eye examinations,” Chiu-Fang Chou, DrPH, of the division of diabetes translation at the National Center for Chronic Disease Prevention and Health Promotion at the CDC, and colleagues wrote. “To develop interventions that increase the use of preventive eye care, we need to better understand why people do not seek care.”

Researchers analyzed patient data from the Behavioral Risk Factor Surveillance System (2006-2010) from 22 states (n=27,699), specifically looking at patients aged at least 40 years diagnosed with diabetes who did not seek eye care in the past 12 months. According to study data, patients were categorized into four groups depending on their responses for not seeking eye care: cost/lack of insurance, no need, no eye doctor/travel/appointment, and other (ie, everything else).

Chou and colleagues found that 23.5% (95% CI, 22.6-4.4) of patients with diagnosed diabetes were not compliant with recommended eye examinations.

The most common reasons cited for not seeking eye care in the past 12 months were no need (39.7%) and cost or lack of insurance (32.3%). Patients also reported no eye doctor/travel/appointment (6.4%) and other (21.5%) as barriers to care.

Further analyses revealed that adults aged 40 to 64 years and women were more likely to report cost or lack of insurance as their main reason for not seeking eye care compared with patients aged at least 65 years (RR=2.79; 95% CI, 2.01-3.89) and men (RR=2.33; 95% CI, 1.75-3.14).

Additionally, patients aged 40 to 64 years were less likely to report no need for eye care (RR=0.51; 95% CI, 0.39-0.67) compared with patients aged at least 65 years.

These findings indicate that targeted interventions and improved public messages are needed to increase eye care among patients with diabetes, specifically to address cost and insurance concerns for patients younger than 65 years and perception of need among those aged at least 65 years.

Disclosure: The researchers report no relevant financial disclosures.

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