Strutton, R;
Du Chemin, A;
Stratton, I;
Forster, AS;
(2016)
System-level and patient-level explanations for non-attendance at diabetic retinopathy screening in Sutton and Merton (London, UK): a qualitative analysis of a service evaluation.
BMJ Open
, 6
(5)
, Article e010952. 10.1136/bmjopen-2015-010952.
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Abstract
Objectives: Non-attendance at diabetic retinopathy screening has financial implications for screening programmes and potential clinical costs to patients. We sought to identify explanations for why patients had never attended a screening appointment (never attendance) in one programme. Design: Qualitative analysis of a service evaluation. Setting: One South London (UK) diabetic eye screening programme. Participants and procedure: Patients who had been registered with one screening programme for at least 18 months and who had never attended screening within the programme were contacted by telephone to ascertain why this was the case. Patients’ general practices were also contacted for information about why each patient may not have attended. Framework analysis was used to interpret responses. Results: Of the 296 patients, 38 were not eligible for screening and of the 258 eligible patients, 159 were not contactable (31 of these had phone numbers that were not in use). We obtained reasons from patients/general practices/clinical notes for non-attendance for 146 (57%) patients. A number of patient-level and system-level factors were given to explain non-attendance. Patient-level factors included having other commitments, being anxious about screening, not engaging with any diabetes care and being misinformed about screening. System-level factors included miscommunication about where the patient lives, their clinical situation and practical problems that could have been overcome had their existence been shared between programmes. Conclusions: This service evaluation provides unique insight into the patient-level and system-level reasons for never attendance at diabetic retinopathy screening. Improved sharing of relevant information between providers has the potential to facilitate increased uptake of screening. Greater awareness of patient-level barriers may help providers offer a more accessible service.
| Type: | Article |
|---|---|
| Title: | System-level and patient-level explanations for non-attendance at diabetic retinopathy screening in Sutton and Merton (London, UK): a qualitative analysis of a service evaluation |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1136/bmjopen-2015-010952 |
| Publisher version: | http://dx.doi.org/10.1136/bmjopen-2015-010952 |
| Language: | English |
| Additional information: | Copyright © The Authors. This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license (http://creativecommons.org/licenses/by/4.0/), which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. This article was published in BMJ Open following peer review and can also be viewed on the journal's website at http://bmjopen.bmj.com/content/6/5/e010952.full |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1493091 |
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