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Factors Associated with Ophthalmology Referral and Adherence in a Teleretinal Screening Program: Insights from a Federally Qualified Health Center.

Publication ,  Conference
Song, A; Johnson, NA; Mirzania, D; Ayala, AM; Muir, KW; Thompson, AC
Published in: Clin Ophthalmol
2022

BACKGROUND: Early detection of ophthalmic conditions such as diabetic retinopathy (DR) and glaucoma is crucial to preventing vision loss. Previous studies have evaluated teleretinal screening programs for DR in well-insured populations. The purpose of this retrospective study was to evaluate a teleretinal screening program in a population of uninsured and underinsured patients seen in a Federally Qualified Health Center (FQHC). METHODS: We conducted a retrospective chart review of patients (age ≥18) who underwent teleretinal imaging (TRI) at a FQHC between January 2015 and September 2019. TRI gradings and patient demographic and clinical information were abstracted. Factors associated with referral for a dilated eye exam by an ophthalmologist, adherence to recommended follow-up dilated eye exam, and ophthalmology visit attendance were examined. RESULTS: 3130 TRIs were graded in 2216 eyes (1107 patients). 65.2% (N = 722) self-identified as Hispanic and 56.3% (N = 623) required interpreter services. Follow-up dilated fundus examination (DFE) was recommended for 388 TRIs, 49% (N = 190) of which were completed within 1 year. Adherence to the recommended ophthalmology exam was not associated with any baseline clinical or demographic characteristics (p > 0.05). Older age, male sex, hypertension, proteinuria, and higher A1c were significantly associated with greater odds of ophthalmology referral based on TRI (all p < 0.05), after adjusting for covariates. Less severe diabetic retinopathy, no insurance coverage, and Hispanic ethnicity were associated with lower odds of attending an ophthalmology visit, regardless of follow-up recommendations based on TRI (all p < 0.05). CONCLUSION: In an FQHC serving predominantly uninsured and underinsured patients, only 49% of recommended DFE were completed within one year. Less severe diabetic retinopathy, lack of insurance coverage, and Hispanic ethnicity were associated with a lower likelihood of having a DFE regardless of recommendation. These results suggest that greater system-level efforts are needed to increase adherence to follow-up eye exams after TRI to ensure sight-saving care for underserved populations.

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Published In

Clin Ophthalmol

DOI

ISSN

1177-5467

Publication Date

2022

Volume

16

Start / End Page

3019 / 3031

Location

New Zealand

Related Subject Headings

  • 3212 Ophthalmology and optometry
  • 1113 Opthalmology and Optometry
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Song, A., Johnson, N. A., Mirzania, D., Ayala, A. M., Muir, K. W., & Thompson, A. C. (2022). Factors Associated with Ophthalmology Referral and Adherence in a Teleretinal Screening Program: Insights from a Federally Qualified Health Center. In Clin Ophthalmol (Vol. 16, pp. 3019–3031). New Zealand. https://doi.org/10.2147/OPTH.S380629
Song, Ailin, Nicholas A. Johnson, Delaram Mirzania, Alexandria M. Ayala, Kelly W. Muir, and Atalie C. Thompson. “Factors Associated with Ophthalmology Referral and Adherence in a Teleretinal Screening Program: Insights from a Federally Qualified Health Center.” In Clin Ophthalmol, 16:3019–31, 2022. https://doi.org/10.2147/OPTH.S380629.
Song A, Johnson NA, Mirzania D, Ayala AM, Muir KW, Thompson AC. Factors Associated with Ophthalmology Referral and Adherence in a Teleretinal Screening Program: Insights from a Federally Qualified Health Center. In: Clin Ophthalmol. 2022. p. 3019–31.
Song, Ailin, et al. “Factors Associated with Ophthalmology Referral and Adherence in a Teleretinal Screening Program: Insights from a Federally Qualified Health Center.Clin Ophthalmol, vol. 16, 2022, pp. 3019–31. Pubmed, doi:10.2147/OPTH.S380629.
Song A, Johnson NA, Mirzania D, Ayala AM, Muir KW, Thompson AC. Factors Associated with Ophthalmology Referral and Adherence in a Teleretinal Screening Program: Insights from a Federally Qualified Health Center. Clin Ophthalmol. 2022. p. 3019–3031.

Published In

Clin Ophthalmol

DOI

ISSN

1177-5467

Publication Date

2022

Volume

16

Start / End Page

3019 / 3031

Location

New Zealand

Related Subject Headings

  • 3212 Ophthalmology and optometry
  • 1113 Opthalmology and Optometry