PATIENTS PRESENTING EMERGENTLY WITH PROLIFERATIVE DIABETIC RETINOPATHY: Follow-up and Factors Associated With Compliance

Retina. 2020 May;40(5):928-935. doi: 10.1097/IAE.0000000000002481.

Abstract

Purpose: To determine the rate of follow-up after emergent encounters for proliferative diabetic retinopathy and to identify patient or visit characteristics associated with follow-up compliance.

Methods: A retrospective cohort study of patients presenting to an ophthalmic emergency department with active proliferative diabetic retinopathy between May 2014 and December 2016 was conducted. Demographic data and encounter data were gathered for each emergency department visit. Compliance with follow-up was defined as a completed clinic visit as scheduled after the emergency encounter.

Results: A total of 590 emergency department encounters were included. The overall follow-up rate was 61.9%. Married patients and those with Public Health Trust insurance had increased odds of compliance (odds ratio [OR]: 1.507, P = 0.04; OR: 2.749, P < 0.0001). Patients with Medicaid had reduced odds (OR: 0.543, P = 0.004). Patients with longer emergency department encounters and longer intervals to follow-up had reduced odds (OR: 0.948, P = 0.001; OR of 0.941, P < 0.0001). The other characteristics were not significantly associated with follow-up compliance.

Conclusion: Patients who present emergently with active proliferative diabetic retinopathy are at high risk of following up noncompliance. Characteristics with significant effects on the odds of follow-up compliance include specific insurance payer, marriage status, length of visit, and interval to follow-up.

MeSH terms

  • Adult
  • Aged
  • Diabetic Retinopathy / diagnosis*
  • Diabetic Retinopathy / therapy
  • Disease Management*
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance*
  • Prognosis
  • Retrospective Studies
  • Time Factors