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17/11/2023

TOPLINE:

A quality improvement (QI) project using mobile diabetic retinopathy (DR) screening units in a primary care setting increased DR screening rates, and also increased knowledge and awareness of DR in adults with type 2 diabetes (T2D).

METHODOLOGY:

The 5-month QI project was implemented at a primary care clinic in a small North Carolina town that encompassed several diverse communities.
The clinic partnered with a local accountable care organization (ACO) that contracts with commercial insurers and Medicare to provide patients with standard of care services.
Approximately 2000 (13%) of the clinic’s adult patients have T2D and nearly half are insured and contracted with that ACO.
A convenience sample of 100 adult patients with T2D met inclusion criteria and 46 participated in DR screening, performed by ACO employees using hand-held cameras.

TAKEAWAY:

The average DR screening rate increased to 52.1% during the 5-month implementation period, from 45.3% during the prior 3 months (P = .018).
This represented a 15% improvement, achieving the project’s first aim.
Of the 46 screened patients, five were found to have DR, including four without a prior DR diagnosis.
Mean questionnaire DR knowledge scores improved from 81.5% pre- to 88.6% post-screening (P = .022).
In the questionnaire, toprol xl 25mg price 83% of patients responded that completing DR screening in their primary care provider’s office was convenient and preferable over other settings.

IN PRACTICE:

“This project addressed gaps of care and demonstrated that primary care settings can increase access to DR screening through a patient-centered process and thereby help to prevent irreversible outcomes of DR and improve quality of life.”

SOURCE:

Conducted by Katherine K. Clark, RN, of LeBauer Healthcare Stoney Creek, Whitsett, North Carolina. Published October 25, 2023, in Clinical Diabetes.

LIMITATIONS:

The unexpected and unavoidable temporary closure of the participating clinic due to urgent building repair need and relocation to two other clinics significantly reduced the sample size; only insured clinic patients were included; and the project had a short duration.

DISCLOSURES:

None.

Miriam E. Tucker is a freelance journalist based in the Washington, DC, area. She is a regular contributor to Medscape, with other work appearing in the Washington Post, NPR’s Shots blog, and Diabetes Forecast magazine. She is on Twitter @MiriamETucker.

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