Teleretinal Screening Completion May Be Affected By Ethnicity, Primary Care Visits

Hispanic race, fewer primary care physician (PCP) encounters, and higher HbA1c are among several factors that affect completion of a diabetic retinopathy teleretinal screening, according to a poster presented at the American Society of Retina Specialists meeting, held in Seattle, July 28 to August 1, 2023.

Researcher Hongan Chen, MD, of the Sue Anschutz-Rodgers Eye Center, University of Colorado Anschutz Medical Campus, led a team in investigating factors associated with completing teleretinal screening for diabetic retinopathy. While the screening initiative has improved patient compliance after its incorporation into primary care, fewer than 3 in 5 patients with diabetes complete an annual dilated eye exam, the report notes.

The researchers reviewed electronic medical records at Denver Health Medical Center and identified adult patients (n=8031) who qualified for teleretinal screening in 2022. The team reviewed patient demographics, HbA1c, the number of PCP visits, diabetes composite score, and preventative care gap scores.

Patients who were Hispanic (OR, 1.3; 95% CI, 1.1-1.5), Spanish-speaking (OR, 1.5; 95% CI, 1.3-1.7), or had fewer PCP visits (OR, 0.76; 95% CI, 0.73-0.79) were more likely to complete the teleretinal screening (P <.0001 for all), the report shows. Higher diabetes composite scores (OR, 1.2; 95% CI, 1.1-1.2; P <.0001) and higher HbA1c (OR 1.0; 95% CI, 1.0-1.1; P =.0038) also positively affected the likelihood of completing the screening.

Individuals with inactive patient portals (OR, 0.64; 95% CI, 0.48-0.84; P =.0016), patients who were retired (OR, 0.70; 95% CI, 0.58-0.84; P <.0001), and individuals with a disability (OR, 0.84; 95% CI, 0.71-0.99; P =.16) were less likely to complete the teleretinal screening. Overall, the screening rate was 42.9%, which is less than the national average of 58.3%.

Age, sex, and insurance type were not associated with screening completion. Overall, individuals of non White race demonstrated a similar likelihood of completing the screening (OR, 0.78) compared with individuals with White ethnicities.  

“This study highlights specific cohorts to target to improve overall [diabetic retinopathy teleretinal screening] completion rates,” according to the presenters.