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Albadrani MS, Alrehaili AM, Alahmadi SH, Aljazaeri AA, Almaghthawi OF, Alanazi SN, Alrehaili OA. Awareness of Diabetic Retinopathy Among Patients With Type 2 Diabetes Mellitus in Primary Healthcare Centers in Madinah, Saudi Arabia: A Cross-Sectional Study. Cureus 2023; 15:e49718. [PMID: 38033448 PMCID: PMC10688576 DOI: 10.7759/cureus.49718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2023] [Indexed: 12/02/2023] Open
Abstract
Background The prevalence of diabetes mellitus (DM) in Saudi Arabia is among the highest in the Middle East and North Africa (MENA) regions. Various complications of DM can cause problems in the long term. One of the most prevalent microvascular problems and the primary cause of blindness is diabetic retinopathy (DR), and a significant proportion of the population with diabetes eventually develop diabetes retinopathy. Recognizing and understanding DR may be crucial for patients in identifying and averting this complication. Objectives The objective of this atudy is to assess the awareness of DR among patients with type 2 DM at primary healthcare centers in Madinah, Saudi Arabia. Methods This cross-sectional study involved a survey of patients with diabetes who attended Madinah primary care clinics between August and September 2023. The study was conducted in Madinah, Saudi Arabia, from May to November 2023. Results A total of 240 patients participated with a median age of 49.7 years and a gender distribution of 121 (50.4%) men. Overall, less than half of patients had a fair level of knowledge (47.1%) and a good level of knowledge (42.1%) about DR, whereas 10.8% had poor knowledge. Physicians were the primary source of information for patients, followed by the internet, family, and friends. Higher levels of education, diabetes that had been present for a longer period, and regular eye exams were associated with better understanding. This study emphasizes the importance of improving patient knowledge and awareness of DR. Conclusions We observed a high level of awareness of DR among participants. Furthermore, higher awareness was associated with longer disease duration and compliance with diabetes treatment.
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Affiliation(s)
- Muayad S Albadrani
- Department of Family and Community Medicine, Taibah University, Medina, SAU
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Ting Yih Ling J, Mohd Zain A, Naffi AA, Mustapha M, Wan Abdul Halim WH. Determination of Factors Influencing the Health Belief Model (HBM) and Adherence to Intravitreal Anti-vascular Endothelial Growth Factor (VEGF) Among Patients With Diabetic Macular Edema (DME). Cureus 2023; 15:e34669. [PMID: 36909105 PMCID: PMC9993440 DOI: 10.7759/cureus.34669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2023] [Indexed: 02/09/2023] Open
Abstract
Background Diabetic macular edema (DME) is becoming one of the leading causes of blindness worldwide with a significant impact on quality of life. The effectiveness of intravitreal (IVT) anti-vascular endothelial growth factor (VEGF) therapy has been established by clinical trials and has become the treatment of choice in the majority of DME patients in reducing macular edema and improving visual acuity. Frequent drop-out and discontinuation of treatment are major issues. Lack of compliance can lead to worsening outcomes and be a burden to patients and the healthcare system. Purpose The purpose of this study is to assess multiple factors that affect adherence to IVT anti-VEGF treatment among patients with DME, including socioeconomic causes and the Health Belief Model (HBM) domains, in addition to exploring the relationship between them. Methods This cross-sectional study was conducted among DME patients in Hospital Canselor Tuanku Muhriz, Kuala Lumpur, Malaysia, from December 2020 to June 2021. We identified eligible patients using a retrospective chart review of clinical findings and optical coherence tomography (OCT) findings. Included subjects were of Malaysian nationality, aged 18 years and above, who were initiated or re-initiated IVT anti-VEGF treatment regime and on follow-up for at least six months from initial injection from January 2019 onwards. A translated and validated self-administered questionnaire was given to the respondents. Data were analyzed using IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, New York, United States). Demographics of the patient were summarized using descriptive statistics, independent sample t-test was used to compare the difference in components of the HBM questionnaire. Linear regression was further used to explore the relationship between patients' demographics and the HBM component. Results A total of 141 patients participated in this study, of whom 56.2% patients were adherent to treatment. The majority were aged 60 years and above (56.7%), male (52.5%), Malay (38.9%), and married (71.6%). There was a significant statistical difference in patients who were adherent to treatment, in terms of life entourage (p=0.004, Fisher Exact test). HBM domains that influenced adherence to treatment included perceived severity, perceived barriers, perceived benefits, cues to action, and self-efficacy (p<0.05, independent sample t-test). Further, multiple logistic regression tests on sociodemographic factors and HBM domains after eliminating confounding factors narrowed down the significant variables to perceived susceptibility (p= 0.023), perceived benefits (p< 0.001), and self-efficacy (p< 0.001). Conclusion Patients' adherence to IVT anti-VEGF is influenced by perceived susceptibility to complications from DME, perceived benefits to the treatment, and self-efficacy.
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Affiliation(s)
| | - Ayesha Mohd Zain
- Ophthalmology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS
| | - Ainal Adlin Naffi
- Ophthalmology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS
| | - Mushawiahti Mustapha
- Ophthalmology, KPJ (Kumpulan Perubatan Johor) Ampang Puteri Specialist Hospital, Kuala Lumpur, MYS
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Abdu M, Allinjawi K, Almabadi HM. An Assessment on the Awareness of Diabetic Retinopathy Among Participants Attending the Diabetes Awareness Camp in Saudi Arabia. Cureus 2022; 14:e31031. [PMID: 36475173 PMCID: PMC9717717 DOI: 10.7759/cureus.31031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2022] [Indexed: 06/17/2023] Open
Abstract
Aim The objective of this study is to assess the level of awareness of the effect of diabetes and diabetic retinopathy (DR) on the eye among a sample of the Jeddah community. Methods A cross-sectional study was conducted among those attending a diabetes awareness camp in Jeddah, Saudi Arabia, in November 2021. Participants were asked to answer questions in a structured questionnaire that was already used in a previous study. Responses were analyzed using Statistical Package for the Social Sciences (SPSS) version 25 (IBM SPSS Statistics, Armonk, NY, USA). Results A total of 352 participants were included in this study, 184 (52.3%) of them were females. Of the participants, only 74 (21%) had diabetes mellitus (DM). The vast majority (94%) of the participants believed that diabetes could affect the eyes, and 94.3% believed that maintaining the level of blood sugar could maintain the eye and the level of vision. Moreover, 77.3% were aware that diabetes could lead to visual impairment and blindness. Around one-third of the total participants and less than half of the diabetic group were found familiar with DR. Although 96% of diabetic participants reported the need for diabetics to get their eyes checked annually, only 70% did so. Lack of awareness of the effect of diabetes on the retina was the main barrier preventing diabetic groups from getting their eye checked. Conclusion Despite the good level of awareness among the community and diabetics about diabetes and its effect on the eyes, there is less awareness that DR is one of the most dangerous complications that lead to visual impairments. These findings assure the importance to raise awareness of DR among the community and diabetics and increase awareness of the importance of annual eye examinations.
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Affiliation(s)
- Mustafa Abdu
- Optometry, College of Applied Medical Science, University of Jeddah, Jeddah, SAU
| | - Kareem Allinjawi
- Optometry, College of Applied Medical Science, University of Jeddah, Jeddah, SAU
| | - Huda M Almabadi
- Optometry, College of Applied Medical Science, University of Jeddah, Jeddah, SAU
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Alhamoud AH, Bajahzer M, Alshahrani M, Alghamdi M, Alaklabi S, Aldhibi H. Awareness of Diabetic Retinopathy Among Diabetic Patients in King Khalid Eye Specialist Hospital, Riyadh, Saudi Arabia. Cureus 2022; 14:e30458. [DOI: 10.7759/cureus.30458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2022] [Indexed: 11/06/2022] Open
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Wahby I, Albeladi F, Abukhudair A, Alyoubi S, Alyoubi S, Alotaibi A, Albeladi A. Awareness of Diabetic Retinopathy Among Patients With Type 2 Diabetes Attending the Outpatient Clinic in the General Hospital in Rabigh, Saudi Arabia: A Cross-Sectional Study. Cureus 2022; 14:e28235. [PMID: 36158427 PMCID: PMC9488857 DOI: 10.7759/cureus.28235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2022] [Indexed: 11/11/2022] Open
Abstract
Introduction: Diabetic retinopathy (DR) is a common microvascular complication of type 2 diabetes (T2D) and a major cause of blindness. DR awareness is important for early identification and management in patients with T2D. This study aimed to estimate the level of awareness of DR and its risk factors among patients with T2D in Saudi Arabia. Methods: We conducted a cross-sectional study to analyze data collected from 291 patients with T2D attending outpatient clinics in the General Hospital in Rabigh during 2020-2021. We collected demographic information and level of awareness about T2D and DR. Results: Among 291 patients with T2D, 42.3% had T2D for more than five years, and 37.8% had T2D for two to five years. In our study population, 32.3% of participants obtained high school education, and 42.3% had moderate income. Over half of respondents (56.4%) had their last eye exam within the past year, and 68.4% of participants believed high blood glucose levels might cause vision problems. The mean ± standard deviation of the DR awareness score was 7.23 ± 2.74. Most participants had moderate level of awareness (39.5% of participants), 31.6% had good level of awareness, and 28.9% had poor level of awareness about T2D and DR. Participants without DR or who had DR for less than two years and those who had their eyes checked by a doctor last year had a significantly higher DR awareness level. Conclusion: We asked patients with T2D to assess their level of DR awareness. Most patients had moderate awareness levels, indicating a need for improved awareness of T2D complication on retina and treatment options. Patients should also be motivated for retinal screening to reduce the risk of visual complications. Furthermore, DR screening programs should not be limited to eye care centers. Improved awareness and access to screening programs will help patients and their healthcare providers achieve optimal outcomes in prevention of DR.
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Chekol GZ, Mengistu D, Tadesse AW. Is the Duration of Diabetes Diseases Positively Associated With Knowledge About Diabetic Complications? Knowledge of Diabetes Mellitus Complications and Associated Factors Among Type-2 Diabetic Patients in Public Hospitals of Addis Ababa, 2020. Front Public Health 2022; 9:812586. [PMID: 35265583 PMCID: PMC8899007 DOI: 10.3389/fpubh.2021.812586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 12/20/2021] [Indexed: 11/13/2022] Open
Abstract
Background Although the importance of educational programs in the prevention and control of diabetes mellitus (DM) and its complication is well-recognized, there are concerns about whether these programs are achieving the desired goal of increasing knowledge of DM and its complication in developing countries. Therefore, this study assessed knowledge of DM complications and associated factors among type-2 diabetic patients in public hospitals of Addis Ababa. Method Simple random sampling technique was used to select 422 participants. Data were entered to EpiData Version 4.6.0.1 and analyzed using SPSS Version 25 software. Multicollinearity and model goodness-of-fit was checked. A multivariate logistic regression model at 95% CI was used to identify the predictors. Result The overall knowledge of diabetes complications among diabetic patients in the Hospitals of Addis Ababa was 54.9%. In the fitted model, being a profession of governmental workers [adjusted odds ratio (AOR) = 3.12, 95% CI (1.33, 7.34)] and merchants [AOR = 2.54, 95% CI (1.16, 5.56)]; DM duration 5–10 years [AOR = 0.41, 95% CI (0.23, 0.73)] and ≥10 years [AOR = 0.36, 95% CI (0.19, 0.69)]; family history of DM [AOR = 1.68, 95% CI (1.03, 2.75)]; and participating in diabetic counseling [AOR = 2.41, 95% CI (1.50, 3.86)] were significantly associated with knowledge about DM complications. Conclusion and Recommendation The overall knowledge of diabetes complications among diabetic patients in the Hospitals of Addis Ababa was 54.9%. It was determined by the duration of DM, current profession, family history, and participation in diabetes counseling. Hence, emphasis on sustaining knowledge about diabetes complications for patients who are more than 5 years since diagnosis and attention is needed about knowledge diabetic farmers.
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Affiliation(s)
- Getachew Zewdu Chekol
- Public of Health Emergency Management, Aletawondo Woreda Health Office, Aleta Wondo, Ethiopia
| | - Daniel Mengistu
- School of Nursing and Midwifery, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Addisu Waleligne Tadesse
- Department of Public Health, College of Health Science, Salale University, Fiche, Ethiopia
- *Correspondence: Addisu Waleligne Tadesse
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Umaefulam V, Premkumar K. Diabetic retinopathy awareness and eye care behaviour of indigenous women in Saskatoon, Canada. Int J Circumpolar Health 2021; 80:1878749. [PMID: 33491596 PMCID: PMC7850356 DOI: 10.1080/22423982.2021.1878749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 12/22/2020] [Accepted: 01/16/2021] [Indexed: 12/03/2022] Open
Abstract
Diabetes is a public health challenge in Canada with a disproportionate number of Indigenous people, especially women, living with diabetes. Diabetic retinopathy is a diabetes ocular complication and a common cause of blindness in Canadian adults. Many individuals living with diabetes do not have regular diabetic eye screening. This study sought to determine the diabetic retinopathy awareness and eye care behaviour of Indigenous women with diabetes or at risk of diabetes. This was a quantitative study among 78 Indigenous women (First Nations and Métis) in Saskatoon, Canada. Data on diabetic retinopathy awareness and eye care behaviour were collected via a knowledge, attitude, and practice survey. Participants had high diabetic retinopathy practice mean scores (32.16) than knowledge (30.16) and attitude scores (22.56). Sub-group analysis showed a significant difference in knowledge scores between age, education, and diabetes status, and differences in practice scores between age and education. Although our regression analysis indicated an association between education and knowledge scores (p = 0.024), and diabetes status and attitude scores (p = 0.044), the associations are not conclusive. Indigenous peoples with or at risk of diabetes may benefit from targeted interventions on diabetes and eye care, which could improve eye care awareness and behaviour.
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Affiliation(s)
- Valerie Umaefulam
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Kalyani Premkumar
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Canada
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Alswaina NF. Awareness of diabetic retinopathy among patients with type 2 diabetes mellitus in Qassim, Saudi Arabia. J Family Med Prim Care 2021; 10:1183-1187. [PMID: 34041148 PMCID: PMC8140237 DOI: 10.4103/jfmpc.jfmpc_2231_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/09/2020] [Accepted: 01/05/2021] [Indexed: 12/16/2022] Open
Abstract
Introduction: Diabetic retinopathy (DR) is a well-known complication of diabetes mellitus (DM) and a major cause of vision loss. Increased awareness of DR is crucial for the prevention and early diagnosis of the disease and preservation of vision. The objective of this study is to assess the level of DR awareness in the Qassim region among type 2 diabetic patients. Materials and Methods: A cross-sectional study was conducted among patients who visited diabetic clinics between January and March 2019 in the Qassim region, Saudi Arabia. This study used structured questionnaires to assess awareness and knowledge of DR. The patients were considered to have a good level of DR awareness if they answered more than 60% of the questions correctly. Results: A total of 307 patients with type 2 DM, 201 males (65.5%) and 106 females (34.5%), participated in the current study. The results revealed that 63.5% of the participating patients involved in this study had good knowledge about DR; 86% of the patients had knowledge about the correlation between retinopathy and DM, and 89.9% believed that DR can be prevented by good control of diabetes. Conclusion: The study showed that about two-thirds of the participants were aware of DR, and most of them had knowledge about the relationship between retinopathy and DM. Younger patients and the group with a higher level of education were found to be more aware of DR. Awareness of DR should be correlated with behavioral practices to improve a patient's compliance in attending annual eye examinations.
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Affiliation(s)
- Nayef F Alswaina
- Department of Ophthalmology, College of Medicine, Qassim University, Kingdom of Saudi Arabia
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Diabetic retinopathy screening barriers among Palestinian primary health care patients: a qualitative study. J Diabetes Metab Disord 2020; 19:875-881. [PMID: 33520809 DOI: 10.1007/s40200-020-00575-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 06/19/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Diabetic Retinopathy (DR) screening among Palestinian diabetic patients is limited. To improve the care of our patients, we explored the barriers to DR screening with a qualitative study. METHODS Three focus groups were conducted in the northern West Bank. Patients noncompliant with DR screening were recruited from Primary Health Care clinics. Questions were adapted from similar published studies. Informed consent was obtained and group discussions were audio recorded, transcribed, and analyzed for themes by three researchers. RESULTS Most patients reported financial barriers including the costs of the exam and additional treatments, and transportation to the referral clinic. System related issues were the difficulty of getting appointments and long wait times due to inadequate numbers of ophthalmologists or screening facilities, and physicians failing to recommend screening. Personal concerns related to patients having other priorities, fears about the results, and the negative experiences of family members. Finally, cultural aspects included the stigma of wearing glasses and not doing a test for a condition without symptoms. CONCLUSIONS Barriers to completing retinopathy screening are multidimensional with financial, personal, educational, health system, and cultural factors. These should be taken into consideration by policy makers in order to increase the uptake and quality of service.
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Qaseem Y, Samra S, German O, Gray E, Gill MK. <p>Self-Reported Awareness of Retinopathy Severity in Diabetic Patients</p>. Clin Ophthalmol 2020; 14:2855-2863. [PMID: 33061270 PMCID: PMC7524196 DOI: 10.2147/opth.s267993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 08/18/2020] [Indexed: 11/25/2022] Open
Abstract
Background Diabetic retinopathy (DR) may be asymptomatic in both mild and advanced stages. A patient’s accurate perception of their DR severity may therefore be critical for effective self-management behaviors and understanding the need for timely intervention and follow-up. Purpose To evaluate the relationship between self-reported and actual retinopathy severity in diabetic patients. Methods This study was a single-center cross-sectional survey. Diabetic patients identified by enterprise data warehouse were sent an online questionnaire where they were asked to self-assess for presence of DR and grade their severity. Actual DR grading was determined via chart review. The primary outcome measures were patient-assessed DR severity and agreement with actual DR severity. Results Of 3208 invitations sent, 324 (10%) patients responded and 319 responses were analyzed. The data showed that 39 of 253 (15%) with no DR, 26 of 40 (65%) with mild/moderate DR, and 24 of 26 (92%) with severe DR believed they had DR (p<0.001). Of those with no DR, 214 of 253 (85%) accurately assessed absence of DR. Of those with mild/moderate DR, 25 of 40 (63%) accurately assessed their severity, 14 of 40 (35%) believed they had no DR, and 1 of 40 (3%) believed they had severe DR. In patients with severe DR, 9 of 26 (35%) correctly assessed their severity, 15 of 26 (58%) believed they had mild/moderate DR, and 2 of 26 (8%) believed they had no DR. Conclusion Patients with severe DR were the most likely to report presence of DR, but often underestimated their disease severity. Many with mild/moderate DR did not realize they had DR. This consistent underestimation of severity across all a significant barrier to timely follow-up and treatment necessary to prevent future visual impairment.
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Affiliation(s)
- Yaqoob Qaseem
- Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Sahej Samra
- Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Olga German
- Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Elizabeth Gray
- Biostatistics Collaboration Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Manjot K Gill
- Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Correspondence: Manjot K Gill Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Suite 440, 645 N Michigan Avenue, Chicago, IL60611, USATel +1 312-908-8152 Email
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Alluhaymid YM, Alotaibi FY, Alotaibi AB, Albasha AM, Alnaim AS, Sabi EM, Mujamammi AH. Awareness of diabetic retinopathy among Saudis with diabetes type 2 in Riyadh city. J Family Med Prim Care 2020; 9:4229-4233. [PMID: 33110837 PMCID: PMC7586587 DOI: 10.4103/jfmpc.jfmpc_731_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/11/2020] [Accepted: 06/24/2020] [Indexed: 11/13/2022] Open
Abstract
Objective: To assess awareness of diabetic retinopathy (DR) for Saudis with diabetes mellitus (DM) type 2 in Riyadh City. Methods: A cross-sectional study that used self-administered questionnaires conducted in primary healthcare centers in Riyadh City between October and December 2019. Results: There were 267 Saudi participants with diabetes mellitus type 2 visiting primary healthcare clinics. (52.4%) were aged 40 years or above at time of diagnosis with diabetes. (73%) had diabetes for at least 5 years. Most of the participants have a good blood glucose control and they do home measurements. In regard to DR, (64.4%) of participants had no subjective or objective indicators of retinopathy, and (70%) had visited ophthalmology clinics. Majority of the participants were advised about DR or referred to an ophthalmologist by their primary physician, with the percentages being (64.8%) and (59.6%), respectively. Regarding other risk factors of DR, (19.5%) had a family history of DR, (23.2%) of participant are smokers and (41.6%) were hypertensives. Majority of the participants were aware about all the aspects of DR, its consequences, and appropriate management except the laser therapy. In terms of area of living and education respondents, who lived in the center of Riyadh City and the secondary level or less educated participants had the lowest level of education. Conclusions: Awareness of DR is acceptable but should not lead this information to reduced awareness and educational programs. Outreach researchers' efforts should cover other directions instead awareness of DR.
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Affiliation(s)
- Yousef M Alluhaymid
- College of Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Fawzan Y Alotaibi
- College of Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
| | | | - Abdullah M Albasha
- College of Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
| | | | - Essa M Sabi
- Department of Pathology, Clinical Biochemistry Unit, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ahmed H Mujamammi
- Department of Pathology, Clinical Biochemistry Unit, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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ALHEJJI A, ALSULTAN M, ALSHAREET M, ALKHAMIS F, ALJAAFARY M, ALSHAQAQIQ A, NABOULI M, IBRAHIM ALI S. Knowledge, attitudes, and practices regarding diabetic retinopathy among primary health care physicians in Al-Hasa, Saudi Arabia. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2020; 61:E85-E91. [PMID: 32490273 PMCID: PMC7225646 DOI: 10.15167/2421-4248/jpmh2020.61.1.1229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 12/17/2019] [Indexed: 11/16/2022]
Abstract
Background Diabetic retinopathy (DR) has been shown to be the third most observed cause of visual loss in Saudi Arabia. In the Al-Hasa region in particular, the prevalence of DR has been shown to be 30%. Primary health centre (PHC) physicians play a central role in the early detection and prevention of DR. The aim of this study was to evaluate the knowledge, attitudes, and practices regarding DR of PHC physicians in Al-Hasa, Saudi Arabia. Methods A cross-sectional descriptive study was conducted at PHCs in Al-Hasa, Saudi Arabia. A self-administered questionnaire was provided to every participant along with a consent form. Out of 71 centres in the region, 63 were included in this study. The questionnaire consisted of three sections and a total of 18 questions. Statistical analysis was carried out using the Statistical Package for the Social Sciences version 21 software program (IBM Corp., Armonk, NY, USA). Results One hundred forty-one of 209 physicians completed the questionnaire for a response rate of 67%. The mean of overall knowledge score for all participants was 2.6 ± 1.16 points out of four points. Only 34 (24.1%) of the participants correctly referred their diabetic patients according to the guidelines of the American Academy of Ophthalmology. Additionally, only 52 (36.9%) physicians educated their patients regarding the early detection of diabetic complications. Conclusion The present study concluded that there exist gaps in applying the correct guidelines. Physicians’ attitudes toward patient education were overall satisfactory. Further medical symposiums and workshops are warranted to teach physicians about diabetic complications and screening schedules, including DR.
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Affiliation(s)
- A.E. ALHEJJI
- King Faisal University, Saudi Arabia
- Correspondence: Ahmad Essa Alhejji, Medical Student, King Faisal University, Al-Hasa, Saudi Arabia - Tel. 00966544319914 - E-mail:
| | | | | | | | | | | | - M.R. NABOULI
- Department of Internal Medicine, College of Medicine, King Faisal University, Saudi Arabia
| | - S. IBRAHIM ALI
- Department of Community Medicine, College of Medicine, King Faisal University, Saudi Arabia
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Sadat Mahmoudi Nezhad G, Razeghinejad R, Janghorbani M, Mohamadian A, Hassan Jalalpour M, Bazdar S, Salehi A, Molavi Vardanjani H. Prevalence, Incidence and Ecological Determinants of Diabetic Retinopathy in Iran: Systematic Review and Meta-analysis. J Ophthalmic Vis Res 2019; 14:321-335. [PMID: 31660112 PMCID: PMC6815336 DOI: 10.18502/jovr.v14i3.4790] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Accepted: 04/06/2019] [Indexed: 12/18/2022] Open
Abstract
Purpose
To estimate the pooled prevalence and incidence of diabetic retinopathy (DR) in Iran and to investigate their correlations with the Human Development Index (HDI), healthcare access (i.e., density of specialists and sub-specialists), and methodological issues. Methods
Electronic databases such as PubMed, Embase, Scopus, Web of Science, Google Scholar, and local databases were searched for cohort and cross-sectional studies published prior to January 2018. Prevalence and incidence rates of DR were extracted from January 2000 to December 2017 and random effects models were used to estimate pooled effect sizes. The Joanna Briggs Institute critical appraisal tool was applied for quality assessment of eligible studies. Results A total of 55,445 participants across 33 studies were included. The pooled prevalence (95% CI) of DR in diabetic clinics (22 studies), eye clinics (4 studies), and general population (7 studies) was 31.8% (24.5 to 39.2), 57.8% (50.2 to 65.3), and 29.6% (22.6 to 36.5), respectively. It was 7.4% (3.9 to 10.8) for proliferative DR and 7.1% (4.9 to 9.4) for clinically significant macular edema. The heterogeneity of individual estimates of prevalence was highly significant. HDI (P < 0.001), density of specialists (P = 0.004), subspecialists (P < 0.001), and sampling site (P = 0.041) were associated with heterogeneity after the adjustment for type of DR, duration of diabetes, study year, and proportion of diabetics with controlled HbA1C. Conclusion Human development and healthcare access were correlated with the prevalence of DR. Data were scarce on the prevalence of DR in less developed provinces. Participant recruitment in eye clinics might overestimate the prevalence of DR.
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Affiliation(s)
- Golnoush Sadat Mahmoudi Nezhad
- MPH Department, Shiraz University of Medical Sciences, Shiraz, Iran.,Poostchi Ophthalmology Research Center, Department of Ophthalmology, Shiraz University of Medical Sciences, Shiraz, Iran.,Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
| | | | - Mohsen Janghorbani
- Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran.,Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Mohamadian
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, Shiraz University of Medical Sciences, Shiraz, Iran.,Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hassan Jalalpour
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Somaye Bazdar
- MPH Department, Shiraz University of Medical Sciences, Shiraz, Iran.,Poostchi Ophthalmology Research Center, Department of Ophthalmology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Salehi
- MPH Department, Shiraz University of Medical Sciences, Shiraz, Iran
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Patel N, Verchinina L, Wichorek M, Gardner TW, Markel D, Wyckoff J, Shah AR. Identification of population characteristics through implementation of the Comprehensive Diabetic Retinopathy Program. Clin Diabetes Endocrinol 2019; 5:6. [PMID: 31086678 PMCID: PMC6507149 DOI: 10.1186/s40842-019-0079-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 04/28/2019] [Indexed: 01/22/2023] Open
Abstract
Background Diabetic retinopathy is the most common cause of blindness in working-age adults. Characteristics of patients with diabetes presenting to a retina subspecialty clinic have not been adequately studied, limiting our ability to risk stratify patients with diabetic retinopathy. Our goal is to describe an innovative program that collects structured, longitudinal data on patients with diabetes in a retina clinic, and identifies population characteristics to define patient risk stratification. Methods Demographics, body-mass index, blood pressure, hemoglobin A1c, smoking history, diabetes type, diabetes duration, kidney disease history, and diagnosis codes were collected on all patients with diabetes at the Kellogg Eye Center retina clinic. A mixed effects negative binomial regression was then performed to assess visit frequency as a function of these variables. Visit frequency was used as a marker for cost of care. A subgroup of patients was surveyed about knowledge of diabetes management goals and barriers to better self-management. Results There were 2916 patients in the cohort with 1014 in the subgroup. The cohort was predominantly Caucasian (74.5%), with a mean age of 64 years (range 13–99) and a relatively even distribution of sex (53.2% men). The mean maximum hemoglobin A1c was 8.0% (range 4.3–15.7%), and 57.1% had a diagnosis of diabetic retinopathy. Patients averaged 3.9 visits (range 1–27) during the 18-month study period. Blood pressure and duration of diabetes were positively associated with visit frequency (p < 0.0001, p < 0.0001, respectively). Of the surveyed patients, 87.6% knew their goal hemoglobin A1c, while only 45.9% identified the correct blood pressure goal. The most common reported barrier to better self-management was “it’s just not working” (47.1%). Conclusions Implementation of this program enables the creation of a longitudinal dataset on patients with diabetes. Resulting data can be used to improve quality of care provided to patients at a retina clinic. The findings suggest considerable healthcare resources are being directed to a small patient population. This enhanced understanding of characteristics of patients with diabetes will improve efforts to preserve vision and utilize health system resources efficiently.
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Affiliation(s)
- Nish Patel
- 1University of Michigan Medical School, Ann Arbor, MI USA
| | | | | | - Thomas W Gardner
- 3Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, Michigan Medicine, Ann Arbor, MI USA.,4Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI USA.,6Metabolism, Endocrinology, and Diabetes, Michigan Medicine, Ann Arbor, MI USA
| | - Dorene Markel
- 2The Brehm Center, University of Michigan, Ann Arbor, MI USA.,5Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI USA
| | - Jennifer Wyckoff
- 6Metabolism, Endocrinology, and Diabetes, Michigan Medicine, Ann Arbor, MI USA
| | - Anjali R Shah
- 3Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, Michigan Medicine, Ann Arbor, MI USA
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Abdulaal AE, Alobaid OM, Alotaibi AG, Aldihan KA, Alnasyan AY, Albassam AA, AlSenani MI, Alnasyan A. Diabetic patients' awareness of diabetic retinopathy symptoms and complications. J Family Med Prim Care 2019; 8:49-53. [PMID: 30911480 PMCID: PMC6396597 DOI: 10.4103/jfmpc.jfmpc_349_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background: Diabetes is a very common chronic endocrinological disease. A total of 8.8% of the adult population worldwide was diabetics. Diabetic retinopathy is a silent disease, early detection and intervention is essential for its management and prognosis. Aim: To assess the diabetic patients’ awareness of diabetic retinopathy symptoms and complications. Methods: This is a cross-sectional community-based study which was conducted in Saudi Arabia using a survey from the period between June and September 2018 on all diabetic Saudi participants between 15 and 75 years of age. Results: This study involved 385 participants. The average age of the participants was 47.82 ± 14.49. The study only involved patients who were diagnosed with type 1 diabetes mellites (DM) or 2 DM. And 81% of the samples were diagnosed with type 2 DM. A total of 311 participants were aware of the DM effect on the eye. There was a significant difference between gender regarding the effect of DM on the retina in good control patients. On the subject of the source of participants’ knowledge of DM and its complication, there was a notable difference between groups. Conclusion: An acceptable level of knowledgewas noted among patients. However, some points of knowledge should be increased.
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Affiliation(s)
- Abdullah Eid Abdulaal
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Omar Majed Alobaid
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | | | - Khalid Abdulaziz Aldihan
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | | | | | - Mesaed Ibrahim AlSenani
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Abdulrahman Alnasyan
- Department of Family Medicine, Prince Sultan Primary Health Care, Riyadh, Saudi Arabia
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16
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Alsaidan AA, Ghoraba M. Awareness of diabetic retinopathy among patients with type 2 diabetes mellitus in primary health care in security forces hospital Riyadh, Saudi Arabia. J Family Med Prim Care 2019; 8:2433-2438. [PMID: 31463272 PMCID: PMC6691402 DOI: 10.4103/jfmpc.jfmpc_324_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background Diabetes mellitus (DM) is a metabolic disease that is characterized by distortion in the metabolism of carbohydrates, lipids, and proteins and involves hyperglycemia. DM has different types. Several complications are associated with diabetes including diabetic retinopathy (DR). DR can further results in bad outcomes that can be avoided by early diagnosis and management. Aim The aim of this paper is to assess the awareness and knowledge level about DR among type 2 DM patients in primary health care in security forces hospital. Methods This is a cross-sectional study that was conducted on Saudi patients with type 2 DM who visited primary health care in security forces hospital. Results This study included 174 participants, with equal male to female ratio was 1:1, there were 64.9% participants who reported controlled blood glucose level, and 47.1% reported that eye was affected by diabetes. There were 82.8% participants who had awareness about DR; the level of awareness differs significantly with sex (P value = 0.04) and the level of DM control (P value = 0.02). Conclusion There was high level of knowledge regarding DR; however, there were few percent of participants who had no awareness and still at risk.
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Affiliation(s)
- Aseel Awad Alsaidan
- Family and Community Medicine Department, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Medhat Ghoraba
- Family and Community Medicine Department, Security Forces Hospital, Riyadh, Saudi Arabia
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17
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AlHargan MH, AlBaker KM, AlFadhel AA, AlGhamdi MA, AlMuammar SM, AlDawood HA. Awareness, knowledge, and practices related to diabetic retinopathy among diabetic patients in primary healthcare centers at Riyadh, Saudi Arabia. J Family Med Prim Care 2019; 8:373-377. [PMID: 30984641 PMCID: PMC6436279 DOI: 10.4103/jfmpc.jfmpc_422_18] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Context Diabetic retinopathy (DR) is a microvascular complication for diabetes mellitus (DM), with around 35% of diabetic patients developing some form of DR. Aims This study assessed the awareness toward DR, practice of regular eye examination, and DM control among diabetic patients. Settings and Design This was a cross-sectional study among diabetics at two primary healthcare centers in Riyadh, Saudi Arabia, who were selected by convenience sampling. Methods and Materials The questionnaire contained sections for demography, knowledge, attitude, and practice toward DR, and compliance to DM treatment. The association of awareness about retinopathy with demographics was compared. Statistical Analysis Used The association of awareness about retinopathy and education level with demographics and compliance with treatment were compared using Chi-square test. Results In total, 280 diabetic patients were included, 187 (67%) were males, mean age was 58.9 ± 10.1 years, and median duration of diabetes was 10 years. There was good awareness about DR, diabetes was well controlled in 170 (61%) patients, but less than half (45%) had their eyes checked within 1 year. Patients with education level of high school and above had higher awareness than those with no formal education (P < 0.001). Also, those with income level >10,000 SR had higher awareness than those with income ≤5,000 SR (P < 0.05). Conclusion There was high awareness among the diabetic patients regarding DR but annual check-up was done in less than half of the patients. Improvement is required for scheduling annual eye examinations for the early detection of DR.
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Affiliation(s)
- Manal H AlHargan
- Department of Family Medicine and PHC, King Abdul-Aziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Khalid M AlBaker
- Department of Family Medicine and PHC, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Abdulmajeed A AlFadhel
- Department of Family Medicine and PHC, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Mohammed A AlGhamdi
- Department of Family Medicine and PHC, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Salman M AlMuammar
- Department of Family Medicine and PHC, College of Medicine, AlFaisal University, Riyadh, Saudi Arabia
| | - Haifa A AlDawood
- Department of Family Medicine and PHC, College of Medicine, AlFaisal University, Riyadh, Saudi Arabia
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18
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Fallatah MO. Knowledge, Awareness, and Eye Care-Seeking Behavior in Diabetic Retinopathy: A Cross-Sectional Study in Jeddah, Kingdom of Saudi Arabia. Ophthalmol Ther 2018; 7:377-385. [PMID: 30232621 PMCID: PMC6258583 DOI: 10.1007/s40123-018-0147-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Indexed: 12/03/2022] Open
Abstract
Introduction Diabetes mellitus (DM) is common metabolic disorder that is characterized by increased circulating blood glucose levels. Long-term, continuous hyperglycemia leads to vasculature-related disorders, including those affecting the eyes, such as retinopathy. The objective of this study was to assess the awareness of diabetic complications, specifically diabetic retinopathy, among diabetic patients attending the Jeddah Eye Hospital. Methods This was a cross-sectional study targeting the outpatient clinics of Jeddah Eye Hospital for a period of 2 months. A total of 380 participants were randomly selected based on sample size calculations. A closed-ended questionnaire, generated after an extensive literature review, was distributed among the selected individuals. The questions focused on the participants’ clinical status of DM, socio-demographic characteristics, awareness of eye complications secondary to DM, eye screening, and eye care-seeking behavior. Results The mean age of the patients was 58.3 (standard deviation 10.9) years, and 52.4% of patients were female. The majority (89.7%) of participants had type II DM (T2DM). The level of awareness was satisfactory (92.4%); however, only 10.5% of participants knew the recommended frequency for eye check-ups. The level of awareness of related complications was directly influenced by education level, source of patient information, place of residence, and frequency of follow-up visits. Conclusion The results of this study indicate that although the awareness of diabetes-related eye complications was satisfactory in the patient population, eye care-seeking behavior and frequency of eye check-ups were not optimal. Efforts are needed to promote eye care-seeking behavior in this patient group. Electronic supplementary material The online version of this article (10.1007/s40123-018-0147-5) contains supplementary material, which is available to authorized users.
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Alzahrani SH, Bakarman MA, Alqahtani SM, Alqahtani MS, Butt NS, Salawati EM, Alkatheri A, Malik AA, Saad K. Awareness of diabetic retinopathy among people with diabetes in Jeddah, Saudi Arabia. Ther Adv Endocrinol Metab 2018; 9:103-112. [PMID: 29619207 PMCID: PMC5871062 DOI: 10.1177/2042018818758621] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 01/20/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Diabetic retinopathy (DR) is the most common microvascular complication of diabetes mellitus (DM) and the foremost cause of blindness. This study aimed to assess the level of awareness of DR and its related risk factors among patients with DM in Jeddah, Saudi Arabia. METHODS A cross-sectional study was conducted among patients with DM attending primary health care centers at the Ministry of Health in Jeddah. A structured, pretested, self-administered questionnaire was used to collect information on the sociodemographic and DM- and DR-related characteristics of the patients. RESULTS A total of 377 patients were enrolled. About 82.6% of the patients were aware that DM can affect their eyes, and they listed physicians, ophthalmologists, television, and family members as common sources of information on the topic. About 36% of the patients reported that their doctors had not advised them about it. More than half responded that they did not feel their vision to be affected by DM. More than 58% had never been diagnosed with DR. About 35% did not go to their eye checkups, even though around 59% thought that DR could lead to blindness. Of the 64% of patients whose DM was well controlled, 11% and 25% listed surgery and laser treatment, respectively, as available treatment options for DR. The following factors were found to be significant in relation to the subjects' awareness that DM can affect their eyes: the patients' perception of their doctors' advice about DR; the experience of having their vision affected by DM; the knowledge that DR may lead to blindness; the practice of going to eye checkups. CONCLUSIONS Despite having good awareness about DM and its effects on eyes, the patients exhibited a relative lack of awareness about DR. Considering the association of DR with DM, its increasing magnitude is a potential burden on the community and health systems.
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Affiliation(s)
- Sami H. Alzahrani
- Department of Family and Community Medicine, Faculty of Medicine, King Abdulaziz University, PO Box 80205, Jeddah 21589, Saudi Arabia
| | - Marwan A. Bakarman
- Department of Family and Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Maha S. Alqahtani
- Public Health Administration, Ministry of Health, Jeddah, Saudi Arabia
| | - Nadeem Shafique Butt
- Department of Family and Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Emad M. Salawati
- Department of Family and Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahmad Alkatheri
- Department of Family and Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahmad Azam Malik
- Department of Family and Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Khaled Saad
- Department of Pediatrics, Faculty of Medicine, Assiut University Assiut, Egypt
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Pandey A, Lamichhane G, Khanal R, Rai SKC, Bhari AM, Borroni D, Gautam N. Assessment of visual morbidity amongst diabetic retinopathy at tertiary eye care center, Nepal: a cross-sectional descriptive study. BMC Ophthalmol 2017; 17:263. [PMID: 29282017 PMCID: PMC5745597 DOI: 10.1186/s12886-017-0656-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 12/11/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diabetic retinopathy (DR) is one of the leading causes of preventable blindness in low and middle income countries. In Nepal, there are less studies regarding DR and they too are limited around Kathmandu valley. This study was done to assess visual morbidity in patients with DR at a peripheral tertiary eye care center of Nepal. METHODS This was a prospective, hospital based, cross-sectional study in which all consecutive cases of DR were evaluated. DR was classified according to Early Treatment Diabetic Retinopathy Study Research Group - report no. 10 Table A5-1 (Modified Airlie House Classification). Data entry and analysis was done in an SPSS unit version 20. Wherever applicable, variables were set as 100 eyes. RESULTS Total number of patients included in this study was 50. Commonest age group was 50-69 yrs. (43/77 yrs.; min/max) comprising 80% of the total population (n = 50) and the predominant population was male (76%). Non proliferative diabetic retinopathy (NPDR) was found in 69%, proliferative diabetic retinopathy (PDR) in 31% and advanced diabetic eye disease (ADED) in 3% (n = 100). CONCLUSIONS All the stages of DR were present at significant proportions in this study, noteworthy was the percentage of PDR. This study shows an urgency to gather a national data on DR, raise awareness among diabetics and train effective man power at a local level to diagnose DR at an early stage.
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Affiliation(s)
| | | | | | | | | | | | - Narayan Gautam
- Universal College of Medical Sciences, Bhairahawa, Nepal
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21
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Thevi T, Godinho MA. Predictive factors of visual outcome of Malaysian cataract patients: a retrospective study. Int J Ophthalmol 2017; 10:1452-1459. [PMID: 28944207 DOI: 10.18240/ijo.2017.09.19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 03/31/2017] [Indexed: 11/23/2022] Open
Abstract
AIM To explore the associations between various characteristics of Malaysian cataract patients and their management, and their post-operative visual outcomes, to inform relevant bodies to reduce cataract-related blindness. METHODS We conducted a descriptive secondary data analysis of cataract surgery patients in Melaka Hospital, from 2007 to 2014 using the National Eye Database (NED). Patient-related factors (demographic features, systemic and ocular comorbidities) and management-related factors (surgical duration, type of surgery, type of lens) were analysed for their association with visual outcome (acuity). RESULTS Most patients were Malays (48.23%) and Chinese (38.55%) aged 60-79y (range 0-100y). Hypertension (58.61%) and diabetes (44.89%) were major systemic comorbidities. Glaucoma (6.71%) and diabetic retinopathy (10.12%) were the main ocular comorbidities. Other comorbidities were age-related macular degeneration, pterygium, corneal opacities, macula diseases, vitreous haemorrhage, retinal detachment and pseudoexfoliation (0.70%-1.60%). Preoperatively 7150 (55.03%) eyes presented with poor vision. Uncomplicated phacoemulsification performed quickly with foldable lenses gave good results. CONCLUSION Primary care physicians should initiate early detection to prevent late presentation of cataracts causing poor vision and should discuss the risks and benefits of cataract surgery while emphasizing the role of pre-existing comorbidities which may affect the visual outcomes. For good results, phacoemulsification should be done within 30min, without complications, using foldable posterior chamber intraocular lens.
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Affiliation(s)
- Thanigasalam Thevi
- Department of Ophthalmology, Melaka Hospital, Jalan Mufti Haji Khalil, Melaka 75400, Malaysia
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22
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Konstantinidis L, Carron T, de Ancos E, Chinet L, Hagon-Traub I, Zuercher E, Peytremann-Bridevaux I. Awareness and practices regarding eye diseases among patients with diabetes: a cross sectional analysis of the CoDiab-VD cohort. BMC Endocr Disord 2017; 17:56. [PMID: 28882117 PMCID: PMC5590154 DOI: 10.1186/s12902-017-0206-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 08/29/2017] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The increasing prevalence of diabetes is leading to a rise of eye diseases, augmenting the risk of sight-threatening complications. The aim of this study was to evaluate prevalence, awareness and practices regarding eye diseases among patients with diabetes in the canton of Vaud, Switzerland. METHODS A cohort of 323 patients with diabetes completed a self-administered questionnaire assessing prevalence, awareness and practices regarding eye diseases, besides health status and quality of care measures. Descriptive analyses followed by exploratory subgroup analyses and linear regressions were performed to investigate factors associated with awareness and practices. RESULTS While diabetic retinopathy was reported by 40.9% of patients with type 1 diabetes and 9.8% of patients with type 2 diabetes, 35.8% and 12.6% of all participants reported cataract and glaucoma, respectively. Awareness that diabetes could damage the eyes was reported by almost all participants; the majority was also aware of the importance of glycemic control and regular eye examination in preventing eye diseases. In contrast, only 70.5% of participants underwent an eye examination by an ophthalmologist during the past year. Eye examination was associated with better patients' awareness. Barriers mentioned by patients revealed a lack of knowledge about screening guidelines, in particular regarding the preventive nature of eye examinations. CONCLUSIONS Despite high levels of awareness regarding diabetic eye diseases, a significant proportion of patients with diabetes did not report annual eye examination. Both healthcare strategic efforts targeting the promotion of regular eye examination and initiatives aiming at improving knowledge of screening guidelines should be encouraged. TRIAL REGISTRATION ClinicalTrials.gov on 9th July 2013, identifier NCT01902043 (retrospectively registered).
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Affiliation(s)
- Lazaros Konstantinidis
- Jules Gonin University Eye Hospital, University of Lausanne, Avenue de France 15 - Case Postale 5143 - 1000 Lausanne 2, Lausanne, Switzerland
| | - Tania Carron
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | | | - Léonie Chinet
- Public Health Service, Department of Health and Social Action, Canton of Vaud, Lausanne, Switzerland
| | - Isabelle Hagon-Traub
- Public Health Service, Department of Health and Social Action, Canton of Vaud, Lausanne, Switzerland
| | - Emilie Zuercher
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Isabelle Peytremann-Bridevaux
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Bakkar MM, Haddad MF, Gammoh YS. Awareness of diabetic retinopathy among patients with type 2 diabetes mellitus in Jordan. Diabetes Metab Syndr Obes 2017; 10:435-441. [PMID: 29066926 PMCID: PMC5644565 DOI: 10.2147/dmso.s140841] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Increasing the level of awareness of diabetic retinopathy among individuals with type 2 diabetes mellitus is considered an important factor for early diagnosis and management of diabetic retinopathy. The aim of this study was to evaluate awareness of diabetic retinopathy among a sample of type 2 diabetes mellitus patients in Jordan. PATIENTS AND METHODS The study period was from August to December 2015. The sample was selected randomly from patients with type 2 diabetes mellitus from the general population in three main cities of Jordan (Amman, Irbid, and Zarqa). A questionnaire was distributed to 237 participants with diabetes to assess their awareness and knowledge of diabetes and diabetic retinopathy. The questionnaire included questions to assess awareness about diabetic retinopathy, sources of knowledge about the disease, and patients' knowledge and compliance with available treatments and routine eye examinations. Patients were also questioned about the barriers that may interfere with early eye examination. RESULTS A total of 237 participants (107 [45.1%] females and 130 [54.9%] males) with type 2 diabetes were interviewed. Mean age±SD for the study population was 54.51±10.28 years. Of the study population, 88.2% were aware that diabetes can affect the eyes and 81% reported that diabetic retinopathy can lead to blindness. Higher level of patients' awareness of diabetic retinopathy was related to higher level of formal education (p<0.05). The main source of information about diabetic retinopathy as reported by 47.3% patients was general practitioners. Patients' compliance with diabetes management was relatively high; however, their compliance with routine retinal assessment was poor, with only a total of 29.5% of participants having had an eye examination in the previous year. CONCLUSION Awareness of the nature and consequences of diabetic retinopathy among patients with diabetes in Jordan is relatively high. However, patients' motivation to undergo retinal assessment was poor in the sample, thus hindering early diagnosis and management.
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Affiliation(s)
- May M Bakkar
- Department of Allied Medical Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
- Correspondence: May M Bakkar, Department of Allied Medical Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, PO Box 3030, Irbid 22110, Jordan, Email
| | - Mera F Haddad
- Department of Allied Medical Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Yazan S Gammoh
- Department of Optometry, Faculty of Pharmacy and Medical Sciences, Al-Ahliyya Amman University, Amman, Jordan
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Murthy GVS, Das T. Diabetic care initiatives to prevent blindness from diabetic retinopathy in India. Indian J Ophthalmol 2016; 64:50-4. [PMID: 26953024 PMCID: PMC4821122 DOI: 10.4103/0301-4738.178152] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
It is estimated that 65 million (17%) of 382 million persons with diabetes mellitus (DM) globally reside in India. While globally 35% persons with DM have diabetic retinopathy (DR), this proportion is reportedly lower in India, other countries in South Asia and China. We reviewed published data from 2008 onwards from PubMed, which ascertained DR in population-based representative samples. We also reviewed the risk factors for DR, on awareness regarding eye complications and on accessing an eye examination. Thirteen research studies have reported on the prevalence of DR among persons with DM; this prevalence was lower than the global level in China, India, and Nepal. Eleven studies reported DR risk factors association. The duration of diabetes and level of glycemic control were universally acknowledged DR risk factors. We identified 7 studies in the Asia region that researched the level of awareness about diabetes eye complications and the practice of accessing an eye examination. Excepting 1 study in China, others reported a significant proportion being aware that diabetes leads to eye complications. But the awareness was not translated into a positive practice-most studies reported only 20-50% of the persons with diabetes actually having had their eyes examined. The present review highlights the observation that the risk factors for DR need an integrated diabetic care pathway where the eye care team has to work in close collaboration and partnership with a diabetic care team has to reduce the risk of blindness from DR.
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Affiliation(s)
- G V S Murthy
- Indian Institute of Public Health, Public Health Foundation of India; Department of Clinical Research, Public Health Eye Care and Disability, International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK,
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25
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Shukla R, Gudlavalleti MVS, Bandyopadhyay S, Anchala R, Gudlavalleti ASV, Jotheeswaran AT, Ramachandra SS, Singh V, Vashist P, Allagh K, Ballabh HP, Gilbert CE. Perception of care and barriers to treatment in individuals with diabetic retinopathy in India: 11-city 9-state study. Indian J Endocrinol Metab 2016; 20:S33-S41. [PMID: 27144135 PMCID: PMC4847448 DOI: 10.4103/2230-8210.179772] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Diabetic retinopathy is a leading cause of visual impairment. Low awareness about the disease and inequitable distribution of care are major challenges in India. OBJECTIVES Assess perception of care and challenges faced in availing care among diabetics. MATERIALS AND METHODS The cross-sectional, hospital based survey was conducted in eleven cities. In each city, public and private providers of eye-care were identified. Both multispecialty and standalone facilities were included. Specially designed semi-open ended questionnaires were administered to the clients. RESULTS 376 diabetics were interviewed in the eye clinics, of whom 62.8% (236) were selected from facilities in cities with a population of 7 million or more. The mean duration of known diabetes was 11.1 (±7.7) years. Half the respondents understood the meaning of adequate glycemic control and 45% reported that they had visual loss when they first presented to an eye facility. Facilities in smaller cities and those with higher educational status were found to be statistically significant predictors of self-reported good/adequate control of diabetes. The correct awareness of glycemic control was significantly high among attending privately-funded facilities and higher educational status. Self-monitoring of glycemic status at home was significantly associated with respondents from larger cities, privately-funded facilities, those who were better educated and reported longer duration of diabetes. Duration of diabetes (41%), poor glycemic control (39.4%) and age (20.7%) were identified as the leading causes of DR. The commonest challenges faced were lifestyle/behavior related. CONCLUSIONS The findings have significant implications for the organization of diabetes services in India.
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Affiliation(s)
- Rajan Shukla
- South Asia Centre for Disability Inclusive Development Research, Indian Institute of Public Health, Public Health Foundation of India, ANV Arcade, 1 Amar Cooperative Society, Kavuri Hills, Madhapur, Hyderabad, Telangana, India
| | - Murthy V. S. Gudlavalleti
- South Asia Centre for Disability Inclusive Development Research, Indian Institute of Public Health, Public Health Foundation of India, ANV Arcade, 1 Amar Cooperative Society, Kavuri Hills, Madhapur, Hyderabad, Telangana, India
- Department of Clinical Research, International Centre for Eye Health, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Souvik Bandyopadhyay
- South Asia Centre for Disability Inclusive Development Research, Indian Institute of Public Health, Public Health Foundation of India, ANV Arcade, 1 Amar Cooperative Society, Kavuri Hills, Madhapur, Hyderabad, Telangana, India
| | - Raghupathy Anchala
- South Asia Centre for Disability Inclusive Development Research, Indian Institute of Public Health, Public Health Foundation of India, ANV Arcade, 1 Amar Cooperative Society, Kavuri Hills, Madhapur, Hyderabad, Telangana, India
| | - Aashrai Sai Venkat Gudlavalleti
- South Asia Centre for Disability Inclusive Development Research, Indian Institute of Public Health, Public Health Foundation of India, ANV Arcade, 1 Amar Cooperative Society, Kavuri Hills, Madhapur, Hyderabad, Telangana, India
| | - A. T. Jotheeswaran
- South Asia Centre for Disability Inclusive Development Research, Indian Institute of Public Health, Public Health Foundation of India, ANV Arcade, 1 Amar Cooperative Society, Kavuri Hills, Madhapur, Hyderabad, Telangana, India
| | - Srikrishna S. Ramachandra
- South Asia Centre for Disability Inclusive Development Research, Indian Institute of Public Health, Public Health Foundation of India, ANV Arcade, 1 Amar Cooperative Society, Kavuri Hills, Madhapur, Hyderabad, Telangana, India
| | - Vivek Singh
- South Asia Centre for Disability Inclusive Development Research, Indian Institute of Public Health, Public Health Foundation of India, ANV Arcade, 1 Amar Cooperative Society, Kavuri Hills, Madhapur, Hyderabad, Telangana, India
| | - Praveen Vashist
- Department of Community Ophthalmology, Dr. R. P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Komal Allagh
- South Asia Centre for Disability Inclusive Development Research, Indian Institute of Public Health, Public Health Foundation of India, ANV Arcade, 1 Amar Cooperative Society, Kavuri Hills, Madhapur, Hyderabad, Telangana, India
| | - Hira Pant Ballabh
- South Asia Centre for Disability Inclusive Development Research, Indian Institute of Public Health, Public Health Foundation of India, ANV Arcade, 1 Amar Cooperative Society, Kavuri Hills, Madhapur, Hyderabad, Telangana, India
| | - Clare E. Gilbert
- Department of Clinical Research, International Centre for Eye Health, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
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