title: Diabetic Retinopathy Screening and Monitoring of Early Stage Disease in Australian General Practice: Tackling Preventable Blindness within a Chronic Care Model.
abstract: BACKGROUND
  Diabetic retinopathy (DR) is the leading cause of preventable blindness in Australia. Up to 50% of people with proliferative DR who do not receive timely treatment will become legally blind within five years. Innovative and accessible screening, involving a variety of primary care providers, will become increasingly important if patients with diabetes are to receive optimal eye care.
  
  
  METHODS
  An open controlled trial design was used. Five intervention practices in urban, regional, and rural Australia partnered with ophthalmologists via telehealth undertook DR screening and monitoring of type 2 diabetes patients and were compared with control practices undertaking usual care 2011-2014.
  
  
  RESULTS
  Recorded screening rates were 100% across intervention practices, compared with 22-53% in control practices. 31/577 (5%) of patients in the control practices were diagnosed with mild-moderate DR, of whom 9 (29%) had appropriate follow-up recorded. This was compared with 39/447 (9%) of patients in the intervention group, of whom 37 (95%) had appropriate follow-up recorded.
  
  
  CONCLUSIONS
  General practice-based DR screening via Annual Cycle of Care arrangements is effective across differing practice locations. It offers improved recording of screening outcomes for Australians with type 2 diabetes and better follow-up of those with screen abnormalities.
authors.affiliation: Discipline of General Practice, School of Medicine, The University of Queensland, Level 8, Health Sciences Building, Royal Brisbane and Women's Hospital, Herston, QLD 4006, Australia.
authors.forename: Lisa
authors.initials: L
authors.lastname: Crossland
authors.affiliation: Discipline of General Practice, School of Medicine, The University of Queensland, Level 8, Health Sciences Building, Royal Brisbane and Women's Hospital, Herston, QLD 4006, Australia.
authors.forename: Deborah
authors.initials: D
authors.lastname: Askew
authors.affiliation: School of Public Health, The University of Queensland, Level 2, Public Health Building, Herston Road, Herston, QLD 4006, Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Ware
authors.affiliation: Strathpine Specialist Centre, Dixon Street, Westfield Strathpine, Strathpine, Brisbane, QLD 4500, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Cranstoun
authors.affiliation: Centre for Vision Research, Westmead Millennium Institute and Discipline of Ophthalmology and Eye Health, University of Sydney, Sydney, NSW 2006, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Mitchell
authors.affiliation: Healthcare Improvement Unit, Healthcare Innovation and Research Branch Clinical Excellence Division, Department of Health, Queensland Government, Level 2, 15 Butterfield Street, Herston, QLD 4006, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Bryett
authors.affiliation: Discipline of General Practice, School of Medicine, The University of Queensland, Level 8, Health Sciences Building, Royal Brisbane and Women's Hospital, Herston, QLD 4006, Australia.
authors.forename: Claire
authors.initials: C
authors.lastname: Jackson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D001766:Blindness / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D003930:Diabetic Retinopathy / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D042241:Early Diagnosis; D005260:Female; D058006:General Practice / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000458:organization & administration*; D008875:Middle Aged; D017146:Models, Organizational; D009885:Ophthalmology / Q000458:organization & administration; D010348:Patient Care Team / Q000458:organization & administration; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D019035:Rural Health Services / Q000458:organization & administration; D017216:Telemedicine / Q000458:organization & administration; D013997:Time Factors; D019037:Urban Health Services / Q000458:organization & administration