Adherence to the American Diabetes Association retinal screening guidelines for population with diabetes in the United States
Abstract
Purpose (1) To assess long-term adherence to American Diabetes Association guideline-recommended retinal screening among population with diabetes in the United States. (2) To determine factors associated with long-term adherence to routine eye screening exams. Methods A retrospective cohort study was conducted in adult patients with diabetes identified from January 2009 to December 2010. Patients were followed until disenrollment, death, or study end date (December 2013). A patient was defined as adherent when having at least one exam in each 12-month period if there was evidence of retinopathy, or at least one exam in each 24-month period if there was no evidence of retinopathy. Multivariate logistic regressions were used to investigate patient demographics and other baseline characteristics associated with adherence to guidelines. Results A total of 204,073 patients were identified; the mean age (SD) was 61 (13) years and 48% were female. Overall, 71.1% were adherent to the retinal screening guidelines during a median of 4.8 years of follow-up including 27.7% who received an eye exam every year. Patient socioeconomic status (younger age, black race, lower income/education), less comorbidity, insulin use, higher specialist copayment plans, and proxies for poor patient behavior (lower adherence to the oral hypoglycemic agents, less diabetes education, hemoglobin A1C >9%) were associated with nonadherence to routine eye screening exams. Conclusion During nearly 5 years of foll…
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African-American patients with diabetes are less likely to undergo annual screening exams for DR.
“African-American patients with diabetes are less likely to undergo annual screening exams for DR4–7.”
From Autonomous AI-assisted diabetic retinopathy screening at primary care is associated with increased presentation to eye care by at risk patients (2026) · cites this paper as [7]
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- Authors
- An, J., Niu, F., Turpcu, A., Rajput, Y., & Cheetham, T. C.
- Affiliations
- Western University of Health Sciences (US)
- Kaiser Permanente (US)
- Genentech (US)
- Corresponding author
- An, JaeJin
- Venue
- Ophthalmic Epidemiology
- Publisher
- Informa UK Limited
- Published
- 2018-01-15
- Volume
- 25
- Issue
- 3
- Pages
- 257-265
- ISSN
- 0928-6586 (ISSN-L)
- 1744-5086
- OpenAlex
- W2784105924
- Cited by
- 55
- References
- 28
- Citations by year
- 2026: 8 · 2025: 5 · 2024: 6 · 2023: 10 · 2022: 7 · 2021: 7 · 2020: 6 · 2019: 5
- FWCI
- 4.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Ophthalmic Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Genentech (C4-175855)
- Topics
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal Imaging and Analysis
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- diabetic retinopathy, retinal screening, guideline adherence, American Diabetes Association guidelines, diabetes mellitus, eye examination, socioeconomic status, health disparities, comorbidities, insulin use, oral antidiabetic drugs, diabetes education, HbA1c, barriers to screening
- MeSH terms
- Diabetes Mellitus, Diabetic Retinopathy, Female, Follow-Up Studies, Humans, Male, Mass Screening, Middle Aged, Retrospective Studies, Societies, Medical, Time Factors, United States, Incidence, Prevalence, Guideline Adherence
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