SCREENING UPTAKE IN A WELL ESTABLISHED DIABETIC RETINOPATHY SCREENING PROGRAMME: THE ROLE OF GEOGRAPHICAL ACCESS AND DEPRIVATION

Abstract

Objective To identify criteria that affect uptake of diabetes retinal screening in a community screening programme using mobile retinal digital photography units.

Research Design and Methods Data from the regional diabetes population-based retinal screening programme and regional ophthalmology laser database were linked to patient postcode (zipcode) data. We used distance from retinal screening event, social deprivation scores and demographic information to identify risk factors for non-attendance at a diabetes retinal screening event. Patients were subdivided into urban (greater than 125,000 population), other urban (3,000 to 125,000) or rural (less than 3,000 population) depending on where they lived. Data was collected from 2004 to 2006 inclusive, and included 15,150 patients, and 32,621 eye screening records.

Results The average age of patients was 63 years (±15 standard deviation) and 54% were male. Mean travel time to retinal screening event varied from 7.1 to 17.0 minutes. For the 12% of missed appointments, patients were more likely to be younger, have longer diabetes duration, have poor HbA1c and blood pressure control, to be smokers, and to lived in deprived areas. Poor attendance was not associated with gender or distance to retinal screening event.

Conclusions Social deprivation is strongly associated with poor attendance at retinal screening events. Time travelled to screening event was not associated with attendance in this study of a mobile retinal screening service which visited General Practitioner surgeries. This data can help inform population-based diabetes retinal screening programmes about improving patient uptake.