Eye screening guideline compliance among diabetic patients without diabetic retinopathy

Purpose: To estimate compliance with eye screening guidelines among people with diabetes mellitus (DM). Methods: Computerized billing records identified 248 patients initially seen in 2007-08 at our eye institute with ICD-9 diagnoses of DM without ocular complications. 203 charts were retrieved for follow-up visit review through 2010. Compliance was defined by follow-up exam frequency and permitted follow-up intervals of 15 months to accommodate scheduling challenges: (1) never returned (2) non-compliant but seen within last 15 months (3) non-compliant and not seen within last 15 months (4) compliant, returned for eye examination at least every 15 months. Results: After excluding 3 patients with diabetic retinopathy, 200 medical records were available for analysis. The N (%) patients in the four compliance groups were: 108 (54%), 30 (15%), 37 (19%), and 25 (12%), respectively. To date, 20 of the 108 patients who did not return for follow-up screenings completed a phone interview. Annual eye exams elsewhere were indicated by 14 (70%); 5 of 6 patients reporting no annual screening gave at least one of the following reasons: no time and/or not worried about their eyes (5/6), no insurance (3/6), no transportation (1/6). Telephone interviews are ongoing and a follow-up questionnaire mailing is planned for those not reached by phone. Conclusions: We found evidence that 19% (39) of patients are receiving annual (within 15 months) eye examinations. Findings to date suggest better access to health insurance and patient education may increase compliance rates.