AN INTERVENTION FOR ENHANCING COMPLIANCE WITH SCREENING RECOMMENDATIONS FOR DIABETIC-RETINOPATHY - A BICOASTAL EXPERIENCE

OBJECTIVE - To determine whether an intervention at both the provider and patient level can increase the utilization of diabetic retinal exa mination among diabetic patients and to compare the results from a com parable study conducted on the East Coast. RESEARCH DESIGN AND METHODS - For the regional intervention study, all diabetic patients 18 years or older who enrolled in a large network-based health maintenance org anization (HMO) in California were identified (n = 19,397). The identi fied diabetic patients received educational materials and a notificati on of their prior diabetic retinal examination status. Also, their pri mary care physicians received the current American Diabetes Associatio n (ADA) guidelines for dilated retinal examinations and a list of pati ents due for diabetic retinal examination. RESULTS - There were 25 and 27% increases in the percentage of diabetic patients who received dia betic retinal examinations in 1995 compared with the percentages in 19 93 and 1994, respectively. The increase in diabetic retinal examinatio ns was most significant after the intervention (odds ratio = 1.4). Fur thermore, the improvements in compliance after the intervention were a lmost identical between the studies implemented on the East and West C oasts. CONCLUSIONS - This study and the prior study demonstrate that s uch a ''reminder'' intervention can improve compliance with diabetic r etinal screening recommendations, A generalizable intervention, such a s this, may be applicable on a national level. For these programs to b e successful, however, HMOs and physicians must have a collaborative r elationship.