糖尿病视网膜病变眼年检障碍因素分析

Factors associated with poor participation in annual eye examination for diabetic retinopathy

目的:使用糖尿病年检依从性调查(CADEES)问卷中文版,对沈阳地区糖尿病患者眼年检情况进行调查研究,并分析相关影响因素。方法:横断面研究。收集2021-11/2022-10在沈阳何氏眼科医院就诊的糖尿病首诊患者,使用CADEES中文版问卷调查患者的既往糖尿病眼年检情况,将过去1a未进行过眼底检查定义为眼年检情况不佳。通过多因素二元逻辑回归方程分析确定与眼年检情况不佳相关的因素。结果:共收集468例患者,男192例,女276例,平均年龄67.42±10.66岁。无糖尿病视网膜病变(DR)患者330例;DR患者138例,其中威胁视力的糖尿病视网膜病变(VTDR)患者88例,未威胁视力的糖尿病视网膜病变(NVTDR)患者50例。34.2%(160例)的患者眼年检情况不佳。多因素逻辑回归方程分析发现,在控制了性别、年龄等其他影响因素下,农村患者(OR=1.704,95%CI:1.019~2.850,P=0.042)、VTDR(OR=1.948,95%CI:1.145~3.313,P=0.014)、CADEES问卷的条目7(在过去的4wk,我感到忧郁、消沉或沮丧)(OR=0.624,95%CI:0.401~0.971,P=0.037)和条目42(相应眼科机构每次会及时提醒我该进行眼睛检查)(OR=0.618,95%CI:0.387~0.989,P=0.045)是眼年检参与不佳的危险因素。结论:在沈阳地区可能约有1/3的DM患者没有遵循DR眼年检指南。医疗服务机构应该加强DR健康教育,可通过必要的提醒来提高眼年检参与度。

AIM:To investigate the annual eye examination of diabetic patients in Shenyang and analyze the associated factors by using the Chinese version of the Compliance with Annual Diabetic Eye Exam Survey(CADEES)questionnaire.METHODS:This is a cross-sectional study.The diabetic patients who first visited Shenyang He Eye Specialist Hospital from November 2021 to October 2022 were collected.The Chinese version of the CADEES questionnaire was used to investigate the previous annual eye examinations of these patients,and no fundus examination in the past 1a was defined as poor participation.Factors associated with poor participation in annual eye examinations were identified by multivariate binary logistic regression analyses.RESULTS:A total of 468 patients were collected,including 192 males and 276 females,with an average age of 67.42±10.66 years.There were 330 patients without diabetic retinopathy(DR)and 138 patients with DR,among which 88 patients had vision-threatening diabetic retinopathy(VTDR)and 50 patients had non-vision-threatening diabetic retinopathy(NVTDR).34.2%(160 cases)of patients had poor annual eye examination.The multivariate logistic regression analysis showed that,after controlling gender,age and other influencing factors,patients in rural area(OR=1.704,95%CI:1.019~2.850,P=0.042),VTDR(OR=1.948,95%CI:1.145~3.313,P=0.014),the item 7(I have felt blue,downhearted,or depressed over the past 4wk;OR=0.624,95%CI:0.401~0.971,P=0.037)and item 42(I receive a reminder from my eye doctor’s office when it is time to schedule an exam;OR=0.618,95%CI:0.387~0.989,P=0.045)of CADEES questionnaire were risk factors for poor participation in the annual ophthalmic examination.CONCLUSIONS:Approximately one-third of diabetic patients in the Shenyang region may not follow the guidelines for DR annual eye examination.Healthcare providers should improve DR health education,increasing eye exam participation through necessary reminders.