Analysis of Patient-Reported Barriers to Diabetic Retinopathy Follow-Up

BACKGROUND AND OBJECTIVES: Close follow-up of diabetic retinopathy (DR) has been linked to improved visual outcomes. This study elucidates patient-identified barriers to DR follow-up in a diverse urban clinic population. PATIENTS AND METHODS: Patients 18 years of age or older with DR or macular edema were interviewed using a 21-question survey on attitudes and barriers toward care. Univariate and multivariate logistic analysis identified barriers associated with noncompliance to follow-up. RESULTS: Two hundred nine patients participated with mean age of 58.2 years and hemoglobin A1c of 8.5%. The most common barriers cited were long waiting times (46.4%), other medical conditions (35.9%), forgetting (28.2%), and inability to leave work (9.1%). In a multivariate analysis, forgetting (odds ratio [OR]: 4.35) and other medical conditions (OR: 1.91) were barriers independently associated with non-compliance. Having proliferative DR was associated with other medical conditions in univariate (OR: 4.60) and multivariate analysis (OR: 4.35). CONCLUSION: Patients with DR who report other medical conditions or forgetting have a higher risk of non-compliance to follow-up.