title: Analysis of reasons for noncompliance with laser treatment in patients of diabetic retinopathy.
abstract: OBJECTIVE
  To identify the underlying reasons for noncompliance among Chinese patients undergoing laser photocoagulation treatment for diabetic retinopathy (DR).
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  A total of 262 patients with DR with indications for panretinal photocoagulation and focal laser treatment were recruited.
  
  
  METHODS
  Those who did not complete the prescribed laser treatment were categorized into 2 types of defaulters: Type 1 defaulters were those who did not initiate laser treatment as scheduled; type 2 defaulters were those who did not complete the entire laser sessions, including terminating midterm or defaulting prompt supplement of laser treatment. A standardized questionnaire was given to the 2 types of defaulters to collect information about the reasons for noncompliance. Data were analyzed and subjected to χ(2) test or Fisher exact statistical tests.
  
  
  RESULTS
  The noncompliance rate was 45.5%, which is significantly greater than some developed countries. Unawareness of the necessity for treatment and unawareness of the importance to complete treatment were 2 main reasons leading to noncompliance, representing 28.8% and 36.0%, respectively. Unawareness of the necessity for treatment and fear of laser treatment were more important for type 1 defaulters (29 vs 6 and 11 vs 0, respectively), whereas unawareness of completeness of laser treatment was overweighed in type 2 defaulters (27 vs 13 patients; all P<0.01). These results were likely related to the lack of knowledge about the potential consequences of DR, the underlying principle of laser treatment, and panretinal photocoagulation procedures.
  
  
  CONCLUSIONS
  Developing appropriate education programs targeting specific reasons will help to improve the compliance in patients with DR.
authors.affiliation: Department of Ophthalmology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Hua
authors.forename: Sijia
authors.initials: S
authors.lastname: Cao
authors.forename: Jing
authors.initials: J
authors.lastname: Cui
authors.forename: David
authors.initials: D
authors.lastname: Maberley
authors.forename: Joanne
authors.initials: J
authors.lastname: Matsubara
mesh_terms: D044466:Asian People / Q000208:ethnology; D001364:Awareness; D002681:China / Q000453:epidemiology; D003930:Diabetic Retinopathy / Q000208:ethnology / Q000601:surgery*; D005260:Female; D006801:Humans; D017075:Laser Coagulation; D008297:Male; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D011446:Prospective Studies; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
references.citation: Int Ophthalmol Clin. 1987 Winter;27(4):254-64
references.pmid: 3692707
references.citation: Am J Prev Med. 2008 Mar;34(3):185-91
references.pmid: 18312805
references.citation: Ophthalmology. 1998 Jun;105(6):998-1003
references.pmid: 9627648
references.citation: Ophthalmic Surg. 1980 Apr;11(4):235-45
references.pmid: 6155650
references.citation: Med Care. 2007 Aug;45(8):767-74
references.pmid: 17667311
references.citation: Ophthalmology. 2006 Aug;113(8):1372-7
references.pmid: 16769120
references.citation: Ophthalmology. 1985 Nov;92(11):1532-7
references.pmid: 4080327
references.citation: JAMA. 2007 Aug 22;298(8):902-16
references.pmid: 17712074
references.citation: Diabetes Educ. 1997 Nov-Dec;23(6):653-5
references.pmid: 9416028
references.citation: Am J Public Health. 1994 Oct;84(10):1669-71
references.pmid: 7943494
references.citation: Arch Ophthalmol. 1985 Dec;103(12):1796-806
references.pmid: 2866759
references.citation: Graefes Arch Clin Exp Ophthalmol. 2008 Nov;246(11):1519-26
references.pmid: 18604548
references.citation: Ann Intern Med. 1996 Jan 1;124(1 Pt 2):164-9
references.pmid: 8554212
references.citation: Retina. 2007 Sep;27(7):816-24
references.pmid: 17891003
references.citation: Ophthalmology. 2007 Mar;114(3):525-36
references.pmid: 17123615
references.citation: Saudi Med J. 2005 May;26(5):836-41
references.pmid: 15951879
references.citation: Ophthalmologica. 2008;222(1):32-6
references.pmid: 18097178
references.citation: Arch Ophthalmol. 1984 Apr;102(4):527-32
references.pmid: 6367725
references.citation: Ophthalmology. 1992 Sep;99(9):1351-7
references.pmid: 1407968
references.citation: Diabetes Care. 1999 May;22(5):752-5
references.pmid: 10332676
references.citation: Diabetes Care. 1994 Aug;17(8):909-17
references.pmid: 7956643
references.citation: Invest Ophthalmol Vis Sci. 1989 Jan;30(1):23-8
references.pmid: 2912911
references.citation: Med Care. 1991 Jan;29(1):20-39
references.pmid: 1898753
references.citation: Arch Ophthalmol. 1995 Sep;113(9):1144-55
references.pmid: 7661748
references.citation: Ophthalmology. 1984 Dec;91(12):1464-74
references.pmid: 6521986
references.citation: Ophthalmic Epidemiol. 1999 Mar;6(1):61-72
references.pmid: 10384685
references.citation: BMC Health Serv Res. 2011 Oct 04;11:250
references.pmid: 21970365
references.citation: Ophthalmology. 1991 May;98(5 Suppl):766-85
references.pmid: 2062512
references.citation: Am J Prev Med. 2007 Oct;33(4):318-35
references.pmid: 17888859
references.citation: Ophthalmology. 1991 May;98(5 Suppl):741-56
references.pmid: 2062510
references.citation: N Engl J Med. 2010 Mar 25;362(12):1090-101
references.pmid: 20335585
references.citation: Am J Ophthalmol. 1995 Jun;119(6):760-6
references.pmid: 7785691
references.citation: Diabetes Care. 2004 Jan;27 Suppl 1:S84-7
references.pmid: 14693935
references.citation: Middle East Afr J Ophthalmol. 2011 Apr;18(2):93-7
references.pmid: 21731317
references.citation: Ophthalmology. 2003 Oct;110(10):1952-9
references.pmid: 14522771
references.citation: Ophthalmology. 1981 Jul;88(7):583-600
references.pmid: 7196564
references.citation: Ann Intern Med. 1992 Apr 15;116(8):683-5
references.pmid: 1546870
references.citation: Ophthalmology. 1986 Jul;93(7):938-50
references.pmid: 3763140
references.citation: J Diabetes Sci Technol. 2009 May 01;3(3):509-16
references.pmid: 20144289
references.citation: Arq Bras Oftalmol. 2010 May-Jun;73(3):240-3
references.pmid: 20730280