Understanding/Attitude
There was a common feeling that a ‘hard core’ of nonresponders do not engage with their care and nothing would
influence this.
5. What our findings mean
There are many factors that
practices and screening
programmes across the country
Many patients confused their routine optician’s eye test
appointments (especially if a photograph was taken) and
hospital appointments with retinopathy screening, even in
areas where optometrists were never involved in screening.
Patients didn’t understand that they needed eye
screening because they wouldn’t notice symptoms if
they developed retinopathy.
can focus on, to improve uptake,
according to their contexts.
Research is required targeting GP
practice and screening programme
relationships to promote team work
approaches to diabetic retinopathy
screening.
Patients dislike the dilating drops.
The FLURRI study: understanding
factors affecting low uptake of
diabetic retinopathy screening in
primary care
6. What happens next
The results will be given to the Diabetic Retinopathy Screening Programme
managers, so that they are aware of the issues that have been raised.
Changes in practice should benefit GP practices, screeners and patients.
Research update for study participants
December 2012
:
For more information, contact Professor Jackie Sturt:
Email jackie.sturt@kcl.ac.uk Telephone: 020 7848 3108
1. Introduction
When you agreed to take part in the FLURRI study, we told you that we’d let you
know the results of our research. Thanks to people like you, we have now
finished the study, and have some findings to share with you.
33
The FLURRI Study: update for participants
December 2012
2. Background
People with diabetes
sometimes develop eye
problems that can lead to vision
loss and blindness. This is
known as Diabetic Retinopathy
and can be found early through
screening. Screening involves
patients having digital
photographs taken of their
eyes. These photographs can
find early signs of eye damage
3. What we did
We identified GP and optician
practices in four Primary Care Trusts
that have high numbers of patients
attending their diabetic retinopathy
4. What we found
Factors that contribute
to high attendance levels
Location
screening, and other practices that
have fewer patients who attend. We
went to practices that were in rural
locations, towns, and cities. Some of
Patients living close/ walking
“Everything else is fine, it’s just the drops,
they sting like hell” Patient, Warwickshire
distance to the surgery
“The words ‘Diabetic Retinopathy Screening’ - what does that
mean to them?” GP, Birmingham
Interaction/Communication
these were in poor parts of the
country, others were in wealthier
Practice staff working as a team
areas.
with screeners, including sharing
caused by diabetes, before the
knowledge about patients and
patient becomes aware of any
getting in non-attenders, requiring
symptoms.
flexibility in appointments.
Good rapport between practice
Research has shown that
people who attend the Diabetic
Retinopathy Screening
Programme are less likely to
suffer vision loss or blindness,
compared with people who
and patients overall meant that
communication with the Screening
patients were reminded in other
Focusing on addressable reasons
patients who do not speak/read
Programme as good.
clinics.
why patient might not want to
English well;
A single practice member (clinical
attend (transport/ work/ illness).
Minority ethnic women being
or administrative) taking
Embedding screening as routine
unable to attend their doctor/
(same month every year/
screening without a male relative.
‘remote’ even when visiting
reminding of next appointment).
Transport issues: patients
practices;
attend by phoning the week before
they receive their treatment
Only one GP practice described
Understanding/ Attitude
information inaccessible for
leadership to motivate patients to
don't attend. This is because
“That’s quite a long trip for people to make, even though it’s sort of still in
the same neck of the woods, that’s quite a journey because it’s not like on a
regular bus route or anything.” Screener, Gloucestershire
Lack of flexibility with
appointments at the practice.
Screening services seen as
(especially where staff & patients
experience difficulties getting
For this interview study, we talked to
share the same language). This
home with dilated pupils/not
33 people with diabetes about the
was the factor most often
reasons that they DO attend for their
mentioned as successful.
diabetic retinopathy screening, and the
‘catch-up’ options at surgery or
reasons that they sometimes DON’T
centrally, linking screening with
attend. We asked what puts them off
other care, e.g. blood test, flu jab.
Patients with same surname
Movement of data between
practices and optometrists
out why this is, and what
going to their screening appointment,
Making contact with patients when
within same house and multiple
practices and screening services
Long waiting lists for optometry
would encourage more
and what helps. We also talked to 15
in for screening and talking about
members with diabetes makes
e.g. newly diagnosed patients;
screening appointment.
people to have their eyes
GP practice staff and 11 Diabetic Eye
retinopathy screening (and results)
correct invitation recipient less
results coming back from
Long screening appointment time
photographed every year.
Screening Programme staff.
at diabetes review.
certain for patient and practice;
screening service.
(lasting several hours).
sooner when less damage has
occurred.
At present, not everyone who is
entitled to take part in the
screening, actually attends.
This research aimed to find
Factors that contribute
to low attendance levels
Location
driving.
Involving nurses and Health Care
Assistants in screening seems to
improve communication.
Where screening took place in
Interaction/Communication
high street opticians, poor
communication was frustrating to