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Health education improves referral compliance of persons with probable Diabetic Retinopathy: A randomized controlled trial.

Khair Zara 広島大学

2021.01.29

概要

Type 2 Diabetes Mellitus (T2DM) is on an alarming rise in the world [1]. In 2019, approximately 463 million adults (20–79 years) were living with diabetes and by 2045 this will rise to
700 million [2]. Bangladesh has been identified as one of the top ten countries worldwide in
terms of the number of people living with diabetes [3]. In 2019, there was an estimated 8.4 million people with diabetes in the age bracket 20–79 in Bangladesh, and this number is predicted
to increase to 15 million by 2045 [4].
Diabetic Retinopathy (DR) is the leading cause of vision loss in adults aged 20–74 years,
and the fifth leading cause of global blindness [5,6]. In Bangladesh, the national prevalence of
diabetes is estimated to be 8.4% in population aged 20–79 years, with approximately 56% of
them undiagnosed [4]. The estimated number of individuals with DR in Bangladesh is 1.8 million (21.6% of people with diabetes) [7]. Higher prevalence of DR has been reported in the
coastal areas compared to rural population from other areas of Bangladesh, according to a
study that was conducted in Barishal Division [8].
Since DR is initially asymptomatic, many people with diabetes are not aware that their eye
condition, if left unmanaged, may affect their vision and lead to blindness [9]. Screening and
early intervention is critical—it is more cost effective and may result in better health outcomes
[10,11].
In Bangladesh, DR management is not yet integrated as part of mainstream public health
systems and as such most registered persons with diabetes do not get their eyes routinely
examined [12]. DR management services are largely unavailable in facilities designated for
management of cases of diabetes, where other disease management is prioritized given limited
resources [12]. This may be because of low demand for DR management services possibly due
to lack of awareness about the disease, even among registered persons having diabetes. DR
management services can be very expensive [13]; therefore diabetes hospitals may not cater to
this service in limited-resource settings where demand for services is low.
A large proportion of persons with diabetes are non-compliant with referral to an Ophthalmologist [14] because of lack of awareness about eye complications of diabetes and lack of
information regarding where services are available [15,16]. Published systematic reviews
assessing RCTs found that providing health education regarding DR among persons with diabetes is a promising intervention that resulted in increased DR screening rate [17,18]. ...

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Health education improves referral compliance of persons with probable Diabetic Retinopathy: A randomized controlled trial.

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