Interventions to increase attendance for diabetic retinopathy screening

Citation: Lawrenson JG, Graham-Rowe E, Lorencatto F, Burr J, Bunce C, Francis JJ, Aluko P, Rice S, Vale L, Peto T, Presseau J, Ivers N, Grimshaw JM. Interventions to increase attendance for diabetic retinopathy screening. Cochrane Database of Systematic Reviews 2018, Issue 1. Art. No.: CD012054. DOI: 10.1002/14651858.CD012054.pub2

What is the aim of this review?
The aim of this review was to find out if interventions used to improve attendance for diabetic retinopathy screening are effective.

Key messages
The results of this review found evidence that interventions that target patients, healthcare professionals or the healthcare system are likely to be effective for improving attendance for diabetic retinopathy screening compared to usual care. We found benefits for interventions that were specifically aimed at diabetic retinopathy screening, as well as those which were part of a general strategy to improve diabetes care. This is important, since more general strategies are associated with additional benefits, such as improving blood glucose controland increasing the detection of other diabetes-related complications.

What was studied in the review?
People with diabetes may lose vision as a result of the damaging effects of the disease on small blood vessels at the back of the eye (diabetic retinopathy). Screening for diabetic retinopathy to detect and treat early signs can prevent sight loss. However, screening attendance is variable and sight-threatening changes may not be detected in good time.

This review looked at a variety of interventions to improve diabetic retinopathy screening.

What are the main results of the review?
The Cochrane review authors found 66 relevant studies. Forty-one studies were from the USA, 14 from Europe, three from Canada, three from Australia and five from elsewhere. Fifty-six studies compared the intervention to improve screening attendance with usual care and 10 compared a more intensive to a less intensive intervention.

We found that interventions aimed at patients or healthcare professionals or both, or at the healthcare system were effective at improving screeningattendance. Interventions aimed at improving the general quality of diabetes care worked as well as those specifically aimed at improving screening for retinopathy. On average, attendance increased by 12% compared with no intervention.

How up-to-date is this review?
The Cochrane review authors searched for studies that had been published up to 13 February 2017.

Photo: Screening for diabetic retinopathy (DR)
© Dwi Ananta, HKI.
Published in: Community Eye Health Journal Vol. 25 No. 78 2012
Attribution-NonCommercial 2.0 Generic (CC BY-NC 2.0)