Patients with a diabetes-related eye condition who are male, Black or Hispanic are more likely to miss follow-up appointments after treatment, putting their vision at risk, a study has found.
The research also showed that patients with diabetic retinopathy – the most common cause of vision loss in people with diabetes – who lived further away from a treatment centre, were also more likely to skip vital follow-up appointments.
Diabetic retinopathy occurs when high blood sugar damages the retina. It can cause complications including abnormal growth of blood vessels and diabetic macular oedema, where retina blood vessels leak fluids. Both complications can cause loss of vision.
- Severe eye condition associated with popular diabetes drug
- Screening for eye disease can also detect liver damage
- Eye stroke: Link between semaglutide and eye condition identified
Diabetic retinopathy is treated with either laser therapy or anti-VEGF (vascular endothelial growth factor) injections.
Experts say that consistent treatment and follow-up is vital for both types of treatment, so researchers set out to examine the sociodemographic and clinical factors involved in patients being ‘lost to follow-up’.
A team from Unity Health, Sunnybrook Health Sciences Center and the University of Toronto analysed medical data for 2,961 patients who were treated by either Radha Kohly, a medical retina specialist at Sunnybrook or Rajeev Muni, a vitreoretinal surgeon at St. Michael’s Hospital.
Individuals were classed as ‘lost to follow-up’ if they underwent a treatment but did not attend a follow-up appointment with their specialist in the 12 months following.
The key findings from the study were:
- 17% of patients were ‘lost to follow-up’ over the 10-year study period
- Of those, 41% were permanently lost to follow-up and never returned to the clinic
- Of the 17%, 54% came back at some point after the one-year period.
Male or Hispanic patients were 20 to 50% more likely to be ‘lost to follow up’, with researchers also finding that Black patients were twice as likely to experience gaps in follow-up care.
- Diabetic Retinopathy Treatment
- Diabetic Retinopathy Screening and Tests
- Symptoms of Diabetic Retinopathy
In addition, the study showed that patients who lived more than 20km away from the treatment centre were more at risk of being ‘lost to follow up’, with the risk increasing the further the distance.
The research team made several suggestions to reduce the risk of these population groups being lost to follow up, including specially tailored education resources, automated text messages and phone calls reminders about appointments, and better transportation for those who have to travel further.
The study’s first author, Ryan Huang, a third-year medical student at University of Toronto’s Temerty Faculty of Medicine, said: “This is an ophthalmology study, but we believe it’s widely applicable to all chronic diseases that require regular follow-up and management.”
Read more in JAMA Network Open.
