Telemedicine could improve eye exam access for people with diabetes and in the process prevent blindness caused by diabetic retinopathy, according to researchers.
Currently, less than 65 percent of U.S. adults with diabetes undergo screening for what is considered to be the No. 1 cause of new-onset blindness. Making matters worse, these eye exam rates drop as low as 10 percent to 20 percent for those in underserved populations.
However, virtual eye exams conducted remotely offer a promising solution to better enable diabetic screening, particularly in rural areas where eye doctors are in short supply. Retinal photographs are taken of a patient’s eyes at a primary care physician’s office, and the images are sent over a secure cloud-based network to an eye care provider, who then sends a report back to the PCP.
While telemedicine is just as safe and effective as in-person exams for monitoring diabetic eye disease, it’s not clear whether older adults are open to these kinds of services, says Maria Woodward, MD, assistant professor of ophthalmology at the University of Michigan’s Kellogg Eye Center.
“Until now, little has been known about patients’ attitudes toward telemedicine for diabetic retinopathy,” she says.
Woodward and her colleagues conducted a study of older adults to find out if they would be receptive to telehealth-based exams. Patients were recruited from the Duke University Medical Center and the Durham Veterans Affairs primary care and endocrine clinics.
Attitudes toward the use of telemedicine for diabetic retinopathy screening were very positive, researchers discovered. In a survey of 97 patients, 69 percent indicated that telehealth could be more convenient than traditional one-on-one exams with an eye specialist.
“If you make telemedicine convenient for the patient, that really has a big impact,” says Woodward, who adds that there was no difference based on a patient’s age, gender, race or education level. “People were also more willing to do this if they had a lot of other health problems that made it harder for them to get to the doctor.”
However, she notes that patients were less interested in telehealth if they had been living with diabetes for several years, or if they already had a strong relationship with their current eye doctor. In fact, patients who highly valued the patient–physician relationship had 92 percent lower chances of being willing to participate in telemedicine.
Nonetheless, 48 percent of the patients surveyed reported that they would not miss their relationship with their eye physician.
Results of the study, published in the journal Telemedicine and e-Health, can be found here.
“Patients with better access to care did not believe telemedicine to be more convenient than an in-person eye examination,” conclude the authors. “Therefore, telemedicine programs should focus on individuals who have limited access to care.”
According to Woodward, the National Health Service in the United Kingdom has a nationwide telemedicine diabetic screening program in place where—as a result—diabetic retinopathy is no longer the leading cause of blindness. She would like to see the U.S. follow suit with a similar program.
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