140 lines
4.6 KiB
YAML
140 lines
4.6 KiB
YAML
abstract: 'BACKGROUND: Diabetes mellitus remains the leading cause of new cases of
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blindness among US adults. Routine dilated eye examinations can
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facilitate early detection and intervention for diabetes-related eye
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disease, providing an opportunity to reduce the risk for
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diabetes-related blindness in working-aged Americans. The Healthcare
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Effectiveness Data and Information Set (HEDIS) established criteria for
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performing dilated eye examination in patients with diabetes.
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OBJECTIVES: To obtain information about adherence and nonadherence to
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diabetic eye examinations among insured patients to understand the
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barriers to routine dilated eye examinations, and to identify ways to
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improve the quality of care for these patients.
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METHODS: This retrospective claims analysis is based on administrative
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claims from the HealthCore Integrated Research Database, a broad
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database representing claims from a large commercially insured
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population. Patients with diabetes and who had >= 1 dilated eye
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examinations between August 1, 2011, and July 31, 2013, were defined as
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adherent to the HEDIS recommendations. The analysis was augmented with
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findings from focus groups. The patient focus groups included adherent
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and nonadherent patients. The provider focus group participants were
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general practice or internal medicine physicians and ophthalmologists
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who provided medical care for the study population. For the
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administrative claims analysis, comparisons between the adherent and
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nonadherent patients were performed using t-tests for continuous data
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and chi-square tests for categorical data.
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RESULTS: Of 339,646 patients with diabetes identified in a claims data
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set, 43\% were adherent and 57\% were nonadherent to the HEDIS eye
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examination performance measure. The common barriers to routine eye
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examination cited by 29 patients across 4 focus groups included a lack
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of understanding of insurance benefits (N = 15), a lack of awareness of
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the importance of dilated eye examinations (N = 12), and time
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constraints (N = 12). The common barriers cited by 18 providers included
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the patient''s level of education (N = 13), eye examinations as a lower
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priority than the management of other diabetes-related health issues (N
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= 12), and a lack of symptoms (N = 11).
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CONCLUSION: Several reasons for patient nonadherence to routine eye
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examination were identified, including a lack of understanding of
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insurance benefits, a lack of awareness or low prioritization of having
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an examination, patient education level, time constraints, and a lack of
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symptoms. These may be considered by providers and payers when
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developing programs to increase the rates of eye examinations and
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improve outcomes among patients with diabetes.'
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affiliation: 'Fisher, MD (Corresponding Author), Real World Evidence, Vector Oncol,
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Memphis, TN 38119 USA.
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Fisher, Maxine D., Real World Evidence, Vector Oncol, Memphis, TN 38119 USA.
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Fisher, Maxine D.; Gu, Tao; Singer, Joseph R.; Barron, John, HealthCore, Wilmington,
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DE USA.
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Rajput, Yamina; Ryu, Seonyoung, Genentech Inc, San Francisco, CA 94080 USA.
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Marshall, Amanda R., HealthCore, Res Data Collect, Wilmington, DE USA.
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MacLean, Catherine, Hosp Special Surg, 535 E 70th St, New York, NY 10021 USA.'
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author: Fisher, Maxine D. and Rajput, Yamina and Gu, Tao and Singer, Joseph R. and
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Marshall, Amanda R. and Ryu, Seonyoung and Barron, John and MacLean, Catherine
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author_list:
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- family: Fisher
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given: Maxine D.
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- family: Rajput
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given: Yamina
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- family: Gu
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given: Tao
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- family: Singer
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given: Joseph R.
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- family: Marshall
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given: Amanda R.
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- family: Ryu
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given: Seonyoung
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- family: Barron
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given: John
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- family: MacLean
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given: Catherine
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da: '2023-09-28'
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eissn: 1942-2970
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files: []
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issn: 1942-2962
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journal: AMERICAN HEALTH AND DRUG BENEFITS
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keywords: 'adherence; diabetes mellitus; dilated eye examination; HEDIS measures;
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nonadherence; ophthalmologists; primary care physicians'
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keywords-plus: AFRICAN-AMERICANS; CARE; INTERVENTION; KNOWLEDGE; REMINDERS
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language: English
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month: OCT
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number: '7'
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number-of-cited-references: '29'
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pages: 385-392
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papis_id: 08c02c916b9230fc7fe55dff7ba6afde
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ref: Fisher2016evaluatingadherence
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times-cited: '8'
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title: Evaluating Adherence to Dilated Eye Examination Recommendations Among Patients
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with Diabetes, Combined with Patient and Provider Perspectives
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type: Article
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unique-id: WOS:000390354300004
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usage-count-last-180-days: '0'
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usage-count-since-2013: '1'
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volume: '9'
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web-of-science-categories: Health Care Sciences \& Services; Health Policy \& Services
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year: '2016'
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