BMJ子刊:年轻糖尿病患者“糖尿病视网膜病变”筛查是否被忽视?看看英国这篇研究怎么说!

2021-11-11 MedSci原创 MedSci原创

糖尿病眼病包括糖尿病视网膜病变和黄斑病变,是全世界劳动年龄成年人失明的主要原因之一。

糖尿病眼病包括糖尿病视网膜病变和黄斑病变,是全世界劳动年龄成年人失明的主要原因之一。从公共健康的角度来看,很大一部分糖尿病相关的视力丧失可以通过系统层面的方法来预防,包括有针对性的教育、实施良好的社区层面或国家层面的糖尿病视网膜病变筛查(DRS)计划,以及及时的转诊途径以进行进一步调查。

英国最近的一项回顾性分析显示,英格兰的三个大型城市糖尿病筛查项目中超过30万的糖尿病患者的患病率在18-34岁。在控制了其他人口统计学变量(年龄、性别、种族和社会经济贫困)后,该组参加筛查的几率显著低于60岁以上的参考组参与者。

总之,年轻人的糖尿病视网膜病变筛查就诊率始终低于推荐水平。本研究的目的是对英国糖尿病眼睛筛查计划(DESP)中的筛查提供者进行调查,以确定年轻人参加DRS的感知障碍和促成因素,并就提高该人群筛查率的策略的有效性征求意见。

2020年7月,英国视网膜筛查协会的成员被邀请完成一项匿名在线调查,评估37个信念陈述的一致性,并根据行为改变理论领域框架(TDF)进行了评估,为年轻人提供DRS的潜在障碍/促进因素,并进一步调查项目,探索提高DRS策略的有效性。

一共收到140份(24%)回复,大部分来自筛选者/评分者(67.1%)高度一致认为,DESP在提高年轻人出勤率方面发挥了作用(96.4%),还需要做更多的工作来提高出勤率(90.0%)。社会影响、环境背景和资源,包括DRS与糖尿病治疗的其他过程缺乏整合,限制了糖尿病自我管理的能力。其他障碍包括获得筛查服务和安排预约的困难。不到一半(46.4%)的受访者表示,他们有专门的策略来提高年轻人的筛查率。

参与者使用5Likert量表的平均分数(强烈同意=1;某种程度上同意=2;既不同意也不同意=3;某种程度上不同意=4;强烈不同意=5

总的来说,筛查提供者担心筛查在年轻人中的普及情况,尽管许多项目缺乏专门的策略来提高出勤率。DRS与其他糖尿病护理过程缺乏整合相关是年轻人糖尿病自我管理的主要障碍。

参考文献:Prothero L, Lorencatto F, Cartwright M for the EROS Study Investigators, et al Perceived barriers and enablers to the provision of diabetic retinopathy screening for young adults: a cross-sectional survey of healthcare professionals working in the UK National Diabetic Eye Screening Programme BMJ Open Diabetes Research and Care 2021;9:e002436. doi: 10.1136/bmjdrc-2021-002436

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    2022-05-05 gaoxiaoe
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    2021-11-13 zutt
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    2021-11-11 122fbd4am00(暂无昵称)

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