Non-adherence to diabetes microvascular complications follow-up screening in the primary care population: Predictors, associated barriers, and facilitators
Authors' conclusion
Non-adherence to diabetic microvascular complications follow-up screening was suboptimal in Singapore and driven by multi-faceted predictors and barriers. Targeted interventions are needed to improve follow-up screening adherence.
Study context
- Population
- Primary care patients with T2D undergoing Diabetic Retinopathy (DR), nephropathy and foot complication screening, Singapore; mean ± SD age 60.4 ± 9.4 years, 46.9 % women2,012 appointments
- Participants
- 934 patients
- Outcome
- Non-adherence to annual follow-up screening for DR, nephropathy (DN) and foot complications (DFC): failure to attend annual follow-up screening within ± 4 months
- Follow-up
- Annual
Methodological detailslogistic regression, qualitative interviews
- Logistic regression
- Qualitative interviews
Main finding
As reported in the abstract
Non-adherence to DR follow-up screening
27.6 %
n = 186
Non-adherence to DFC follow-up screening
29.8 %
n = 225
Non-adherence to DN follow-up screening
12.7 %
n = 74
Observational data: associations, not effects.
Further findings
Predictors of non-adherence · baseline
- Higher total cholesterol predicted non-adherence (DR)
- Poor self-rated diabetes control predicted non-adherence (DN)
- Higher satisfaction with diabetes support predicted non-adherence (DFC and DN)
- Better self-efficacy was protective (DFC)
- Logistic regression
Barriers/facilitators of screening adherence (qualitative interviews with 36/24 non-adherent/adherent patients and 9 healthcare professionals (HCPs))
- Patient-reported barriers: poor HCP-patient communication and long waiting times
- Facilitator: knowledge about benefits of diabetes complications screening
- Time constraints prevented HCPs from reinforcing the importance of screening
Original publication
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