ArticleBMJ open diabetes research & care2020
Adherence to ophthalmology referral, treatment and follow-up after diabetic retinopathy screening in the primary care setting.
Article in BMJ open diabetes research & care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 50 citations in OpenAlex.
- Diabetic retinopathy treatment cascade and care continuum in the USA: a systematic review.BMJ open · 2026Pooled it
- Manhattan Vision Screening and Follow-Up Study (NYC-SIGHT): optometric exam improves access and utilization of eye care services.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2024Trial
- Autonomous artificial intelligence increases screening and follow-up for diabetic retinopathy in youth: the ACCESS randomized control trial.Nature communications · 2024Trial
- Diabetic Retinopathy in Primary Healthcare in a Brazilian Municipality: A Cross-Sectional Study Using Teleophthalmology.Health care science · 2026Article
- Referral uptake after diabetic retinopathy screening with artificial intelligence-assisted care pathways: a systematic review and meta-analysis.NPJ digital medicine · 2026Article
- Community pharmacist-led educational intervention to recommend ophthalmology visits for patients with diabetes: a cluster randomized controlled trial.Annals of clinical epidemiology · 2026Article
- Assessing adoption of human and AI-enabled diabetic retinopathy screening in primary healthcare settings: findings from a pragmatic trial.Archives of public health = Archives belges de sante publique · 2025Article
- Quantifying Barriers to Diabetic Eye Screening: A Two-Center Study at the University of California.Diabetes care · 2025Observational
- Article
- Integrating Nursing-Teleophthalmology Improves Diabetic Retinopathy Screening in Primary Healthcare, Reducing Unnecessary Referrals to Specialist Healthcare.International journal of nursing practice · 2025Article
- Measures of diabetic retinopathy treatment coverage: protocol for a methodological review.BMJ open · 2025Article
- Use of serum long non-coding RNA expression panel as a marker for diabetic retinopathy.Frontiers in cardiovascular medicine · 2025Article
- Physician-to-Physician eConsultations to Ophthalmologists at an Academic Medical Center.Translational vision science & technology · 2024Article
- Impact of the Coronavirus Disease 2019 Pandemic on Outpatient Visits for Diabetic Retinopathy in Japan: A Retrospective Cohort Study.Translational vision science & technology · 2024Article
- Follow-up in a point-of-care diabetic retinopathy program in Pittsburgh: a non-concurrent retrospective cohort study.BMC ophthalmology · 2024Article
- Transfers between health facilities of people living with diabetes attending primary health care services in the Western Cape Province of South Africa: A retrospective cohort study.Tropical medicine & international health : TM & IH · 2024Article
- Medical education and physician training in the era of artificial intelligence.Singapore medical journal · 2024Article
- Barriers to Implementation of Teleretinal Diabetic Retinopathy Screening Programs Across the University of California.Telemedicine journal and e-health : the official journal of the American Telemedicine Association · 2023Article
- Risk Factors and Outcomes of Delayed Presentation of Diabetic Retinopathy Patients to a County Hospital.Translational vision science & technology · 2023Article
- Factors Associated with Follow-Up Adherence After Teleophthalmology for Diabetic Eye Screening Before and During the COVID-19 Pandemic.Telemedicine journal and e-health : the official journal of the American Telemedicine Association · 2023Article
Corrections and comments
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Authors and funding
10 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionTelemedicine-based diabetic retinopathy screening (DRS) in primary care settings has increased the screening rates of patients with diabetes. However, blindness from vision-threatening diabetic retinopathy (VTDR) is a persistent problem. This study examined the extent of patients' adherence to postscreening recommendations. RESEARCH DESIGN/
methodsA retrospective record review was conducted in primary care clinics of a large county hospital in the USA. All patients with diabetes detected with VTDR in two time periods, differing in record type used, were included in the study: 2012-2014, paper charts only; 2015-2017, combined paper charts/electronic medical records (EMRs), or EMRs only. Adherence rates for keeping initial ophthalmology appointments, starting recommended treatments, and keeping follow-up appointments were determined.
resultsAdequate records were available for 6046 patients; 408 (7%) were detected with VTDR and recommended for referral to ophthalmology. Only 5% completed a first ophthalmology appointment within recommended referral interval, 15% within twice the recommended interval, and 51% within 1 year of DRS. Patients screened in 2015-2017 were more likely to complete a first ophthalmology appointment than those in 2012-2014. Ophthalmic treatment was recommended in half of the patients, of whom 94% initiated treatment. A smaller percentage (41%) adhered completely to post-treatment follow-up. Overall, 28% of referred patients: (1) kept a first ophthalmology appointment; (2) were recommended for treatment; and (3) initiated the treatment. Most patients failing to keep first ophthalmology appointments continued non-ophthalmic medical care at the institution. EMRs provided more complete information than paper charts.
conclusionsReducing vision impairment from VTDR requires greater emphasis on timely adherence to ophthalmology referral and follow-up. Prevention of visual loss from VTDR starts with retinopathy screening, but must include patient engagement, adherence monitoring, and streamlining ophthalmic referral and management. Revision of these processes has already been implemented at the study site, incorporating lessons from this investigation.
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