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Diabetics cite many reasons for noncompliance with dilated eye exams
A lack of understanding of insurance benefits was the most common barrier in adherence to dilated eye examinations among patients with diabetes, according to a study in American Health & Drug Benefits.
Researchers sought to estimate the proportion of commercially insured people with diabetes who received at least one dilated eye examination over a 2- year study period and to understand the barriers to routine dilated examinations from the patient and provider perspectives.
Of 339,646 patients with diabetes identified in this retrospective claims analysis, 43% were adherent and 57% were nonadherent to the HEDIS eye examination performance measure.
After a lack of understanding of insurance benefits, insufficient awareness of the importance of eye examinations and time constraints were reported.
For 33% of patients, out-of-pocket costs, including insurance copays and medication costs, were additional reported barriers.
Researchers noted that the lack of a sense of urgency among patients about having a dilated eye examination was a troubling observation, they wrote.
The American Diabetes Association recommends that patients with diabetes have dilated eye examinations performed annually by an ophthalmologist or optometrist to screen for retinopathy, or every 2 to 3 years after at least one normal examination, according to study author Yamina Rajput, MS, senior health economist at Genentech, in an interview with Primary Care Optometry News.
“However, adherence to annual eye examinations has been low, with up to 37% of diabetic adults aged at least 18 years in the U.S. not receiving an examination in the past year,” she said.
This research, and other studies, confirms that patients lack an understanding of their insurance benefits, particularly about their deductible and copays, researchers noted.
“Optometrists can play an important role in informing the patient of the importance of yearly dilated eye exams, informing them of risk of vision loss and how these risks can be minimized by regular monitoring,” Rajput continued.
In addition, optometrists can ensure technical and office support staff provide guidance regarding benefits and insurance coverage, she added. – by Abigail Sutton
Disclosure: The study was supported by Genentech. Rajput is a senior health economist for Genentech.