title: Feedback of personal retinal images appears to have a motivational impact in people with non-proliferative diabetic retinopathy and suboptimal HbA1c: findings of a pilot study.
abstract: OBJECTIVE
  To conduct a pilot study to explore the potential impact of visual feedback of personal retinal images on diabetes outcomes.
  
  
  METHODS
  Twenty-five participants with non-proliferative diabetic retinopathy and suboptimal HbA(1c) (> 53 mmol/mol; > 7%) were randomized to receive visual feedback of their own retinal images or to a control group. At baseline and 3-month follow-up, HbA(1c), standard measures of beliefs, diabetes-related distress and self-care activities were assessed.
  
  
  RESULTS
  In unadjusted models, relative to controls, the intervention group showed significantly greater improvement in HbA(1c) at 3-month follow-up (-0.6% vs. +0.3%, P < 0.01), as well as enhanced motivation to improve blood glucose management (P < 0.05).
  
  
  CONCLUSIONS
  This small pilot study provides preliminary evidence that visual feedback of personal retinal images may offer a practical educational strategy for clinicians in eye care services to improve diabetes outcomes in non-target compliant patients. A fully powered randomized controlled trial is required to confirm these findings and determine the optimal use of feedback to produce sustained effects.
authors.affiliation: Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Vic., Australia. grees@unimelb.edu.au
authors.forename: G
authors.initials: G
authors.lastname: Rees
authors.forename: E L
authors.initials: EL
authors.lastname: Lamoureux
authors.forename: T E
authors.initials: TE
authors.lastname: Nicolaou
authors.forename: L A B
authors.initials: LA
authors.lastname: Hodgson
authors.forename: J
authors.initials: J
authors.lastname: Weinman
authors.forename: J
authors.initials: J
authors.lastname: Speight
mesh_terms: D000368:Aged; D003930:Diabetic Retinopathy / Q000097:blood / Q000473:pathology* / Q000503:physiopathology / Q000628:therapy; D030141:Feedback, Psychological; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009988:Orthoptics / Q000379:methods; D010349:Patient Compliance; D010353:Patient Education as Topic; D010865:Pilot Projects; D057285:Precision Medicine; D012160:Retina / Q000473:pathology*; D012648:Self Care; D063128:Tertiary Health Care; D014739:Victoria; D014786:Vision Disorders / Q000209:etiology / Q000517:prevention & control*; D000078329:Workforce
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human