Diabetic retinopathy knowledge and management approaches of primary care physicians

Diabetic retinopathy knowledge and management approaches of primary care physicians

Aim: We evaluated the level of knowledge on diabetic retinopathy (DR) and management approaches of primary care physicians withimportant roles in preventive health services.Material and Methods: Using a Google form, a 14-item questionnaire was prepared to the family physicians’ knowledge about DRand the examination tools they use and their management approach. This questionnaire was sent to 92 family physicians in Turkeyvia the What’s App Messenger.Results: According to the questionnaire responses, 90 (97.8%) of the family physician centers had a Snellen chart and 91 (98.9%)a direct ophthalmoscope. Among the physicians, 79 (85.9%) did not perform visual acuity examinations for diabetic patients,and 39 (42.4%) did not use an ophthalmoscope. While 34 (37.0%) of the surveyed physicians did not refer diabetic patients to anophthalmologist for DR examinations at all, only 22 (23.9%) referred patients to an ophthalmologist at the time of initial diagnosisand 19 (20.7%) referred patients at 1 year after the initial diagnosis. 10 (10.8%) of the surveyed physicians referred patients to anophthalmologist at 2-year intervals, 4 (4.3%) at 6-month intervals, and three (3.3%) at over 2-year intervals. Among the physicians,64 (69.6%), 57 (62.0%), and 63 (68.5%) were not familiar with the stages of DR, fundus fluorescein angiography, and laser treatmentfor DR, and 60 (65.2%) did not know how to perform intraocular injection treatment methods. A total of 87 (94.6%) physicians stateda need for training programs in DR.Conclusion: DR, an eye complication of diabetes mellitus, is not well understood by family physicians, and more than half ofphysicians referred their patients to an ophthalmologist either late after diagnosis or not at all. It is therefore important for familyphysicians to undergo training programs on DR to increase their effectiveness in primary health care services.

___

  • 1. 24/11/2004 tarihli 5258 numaralı Aile Hekimliği Kanunu. Resmi Gazete 9/12/2004, sayı: 25665, tertip:5, cilt:44.
  • 2. Yau JWY, Rogers SL, Kawasaki R, et al. Global Prevalence and Major Risk Factors of Diabetic Retinopathy. Diabetes Care 2012;35:556-64.
  • 3. Klein R, Lee KE, Gangnon RE, et al. The 25-Year Incidence of Visual Impairment in Type 1 Diabetes Mellitus. Ophthalmology 2010;117:63-70.
  • 4. Estacio RO, McFarling E, Biggerstaff S, et al. Overt albuminuria predicts diabetic retinopathy in hispanics with NIDDM. Am J Kidney Dis 1998;31:947-53.
  • 5. Leske MC, Wu SY, Hennis A, et al. Hyperglycemia, blood pressure, and the 9-year incidence of diabetic retinopathy: The Barbados Eye Studies. Ophthalmology 2005;112:799-805.
  • 6. Chew EY, Davis MD, Danis RP, et al. The effects of medical management on the progression of diabetic retinopathy in persons with type 2 diabetes: The action to control cardiovascular risk in diabetes (ACCORD) eye study. Ophthalmology 2014;121;2443-51.
  • 7. Knatterud GL. Diabetic Retinopathy: Report on Photocoagulation. New England J Med 1976;1017-18.
  • 8. Rajendram R, Fraser-Bell S, Kaines A, et al. A 2-year prospective randomized controlled trial of intravitreal bevacizumab or laser therapy (BOLT) in the management of diabetic macular edema: 24-Month data: Report 3. Arch Ophthalmol 2012;130:972-9.
  • 9. Ziemssen F, Schlottman PG, Lim JI, et al. Initiation of intravitreal aflibercept injection treatment in patients with diabetic macular edema: a review of VIVID-DME and VISTA-DME data. Int J Retin Vitr 2016;2:16.
  • 10. Campochiaro PA, Hafiz G, Shah SM, et al. Sustained Ocular Delivery of Fluocinolone Acetonide by an Intravitreal Insert. Ophthalmology. 2010;117:1393-9.
  • 11. Stefánsson E, Machemer R, de Juan E, et al. Retinal Oxygenation and Laser Treatment in Patients With Diabetic Retinopathy. Am J Ophthalmol 1992;113:36-8.
  • 12. Yanoff. Retina. In: Yanoff, Myron JSD, editor. Opthalmology 5th ed. 2019;532.
  • 13. Soliman, AZ, Silva PS, Diala P A, et al. Awareness of retinopathy and timeliness of follow-up among patients presenting to a diabetes teleophthalmology program. Investigative Oph 1287-1287. Awareness of retinopathy and timeliness of follow-up among patients presenting to a diabetes teleophthalmology program. Invest Ophthalmol Vis Sci 2011;14:1287.
  • 14. Solomon SD, Chew E, Duh EJ, et al. Diabetic retinopathy: A position statement by the American Diabetes Association. Diabetes Care 2017;40:412-8.
  • 15. 25/01/2013 tarihli Aile hekimliği uygulama yönetmeliği; aile sağlığı merkezinin teknik donanımı Madde 24. Resmi Gazete Sayısı. 28539.
  • 16. Biten H, Koç EM, Özçelik DÇ, et al. Evaluation of family medicine residents competency in ophthalmology patient care at primary health care settings. J Clin Exp Investig2016;6.
Annals of Medical Research-Cover
  • Yayın Aralığı: 12
  • Yayıncı: İnönü Üniversitesi Tıp Fakültesi
Sayıdaki Diğer Makaleler

Foreign body aspiration in children

Muharrem ÇAKMAK, Evrim GÜL, Yeliz GÜL, Mehtap GÜRGER, Metin ATEŞÇELİK, Mehmet Yusuf SARI

Evaluation of the frequency/addiction of smartphone use and its effect on sleep quality in university students

Seçil GÜNHER ARICA, Hilal ÖZKAYA, Meryem SERDAR, Hüseyin ACAR, Selma PEKGÖR

Effect of job satisfaction level of nurses on their ethical sensitivity

Esra ANUŞ TOPDEMİR, Seyhan ÇİTLİK SARITAŞ, Zeliha BÜYÜKBAYRAM

Efficacy of robot-assisted gait training combined with botulinum toxin injections in cerebral palsy

Mehtap AYKAÇ CEBİCCİ, Ayşe GÜÇ

Comparison of histomorphological findings of cardinal ligament in patients with and without uterine prolapse

Talip KARACOR, Nurullah PEKER, Pınar KIRICI, Şehmus KAYA, Ayhan YILDIRIM

Evaluation of disease outcome with demographic,clinical and laboratory features of childhood-onset systemic lupus erythematosus: Single center experience

Mehtap AKBALIK KARA, Beltinge DEMİRCİOĞLU KILIÇ, Aslı TÜRKUT YILMAZ, Mithat BÜYÜKÇELİK, Ayşe BALAT

Clinical management of mastodynia in female patients under 35 years of age

Banu KARAPOLAT

Increase in C-peptide levels after resolution of hyperglycemia in patients with type 2 diabetes mellitus: Myths or facts?

Bahri EVREN, İbrahim ŞAHİN, Ömercan TOPALOĞLU, Saim YOLOĞLU, Şelale ŞAHİN

Effects of polypropylene mesh on the component separation technique in complex incisional hernia surgery

Tahsin ÇOLAK, Tolga ÖLMEZ

Short-segment pedicle screw-based semi-rigid stabilization with poly (etheretherketone) rods for treatment of degenerative lumbar scoliosis in elderly patients

Göktuğ AKYOLDAŞ