Study: Patients With A Disease History Are More Likely to Follow Up

Portrait of an Ethiopian man wrapped in a blanket with a cross tattooed on his forehead begging for food on a street of Debark, Amhara Region, Ethiopia
A study out of Ethiopia shows factors associated with good check-up practices.

The longer a patient has had a diabetes diagnosis, the more likely they are to understand the risk of diabetic retinopathy and follow-up appropriately, according to research published in BMC Ophthalmology. The study also associated a history of eye disease with better follow-up.

The cross-sectional study was conducted at Debark Hospital, Northwest Ethiopia. A pretested interviewer administered a structured questionnaire to 230 patients with diabetes aged 18 years and older. It covered diabetic retinopathy, eye check-up practice, and associated factors of diabetic retinopathy in this patient population. Out of a total of 230 participants, 119 (51.7%) were male and the mean age of respondents was 49 (SD ± 17.6) years.

Results were entered into software for analysis, with bivariable and multivariable binary logistic regression conducted. “Good knowledge” of diabetic retinopathy was defined as those who scored the mean or higher (≥ 5.55) on questions specifically about knowledge of the condition; those who scored below the mean were considered to have “poor knowledge.”

Researchers found that 109 people (47.4%) had “good knowledge” of diabetic retinopathy. These factors were associated with increased understanding: urban residence [AOR = 2.65; 95% CI, 1.16-6.07)]), monthly income of 3501-8000 birr [AOR = 4.54 (1.31-15.7)], type 2 diabetes mellitus [AOR = 3.9 (1.6-9.6)], duration of diabetes (6-12 years [AOR = 4.4 (1.4-13.5)]), and history of eye disease [AOR = 5.5 (2.3-13.0)].

Only 39.6% had good eye check-up practice. But researchers found that longer duration of diabetes (13-25 years [AOR = 3.77- (1.05-13.5)]) and history of eye disease [AOR = 2.47 (1.09–5.62)] were both associated with good eye check-up practice.

“From the findings of this study, we recommend the national, regional, zonal, and Debark Hospital health authorities to set a guideline that includes advice for diabetic patients about diabetic retinopathy as one component of the standard treatment guideline,” according to the researchers. 

“Moreover, it is better if the national, regional, and zonal mass media and the hospital coordinator set a regular time to deliver education about diabetic retinopathy and other diabetic complications with the aim of improving the knowledge and eye check-up practice of patients with diabetes mellitus,” investigators report.

The study’s limitations include possible recall bias when patients answered some questions, such as about their history of eye disease, if they did not remember their previous ocular diagnoses. The design of the study did not let researchers account for the attitude of participants toward eye check-up practice. 


Assem AS, Tegegne MM, Alemu DS, Woredeka AS, Tefera TK. Knowledge about diabetic retinopathy, eye check-up practice and associated factors among adult patients with diabetes mellitus attending at debark hospital, Northwest Ethiopia. BMC Ophthalmol. 2020;20(453):3-11. doi: 10.1186/s12886-020-01730-4