Diabetic Retinopathy (DR) screening programme in Urban area-Lessons learned.
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Diabetic Retinopathy (DR) screening programme in Urban
area-Lessons learned.
Kuldeep Dole, Sucheta Kulkarni, Madan Deshpande,Nilesh Kakade,
H.V.Desai Eye Hospital&
Rishi Raj Borah ,
ORBIS International,India
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Diabetic Retinopathy Screening Programme- SAVE YOUR SIGHT
GoalReducing morbidity and disability and improvequality of life for persons with diabetic Retinopathy.
Objectives• To generate awareness about Diabetic Retinopathy.• To identify patients with Diabetic Retinopathy by screening diabetics in the hospital and community .• To provide appropriate Management of Diabetic
Retinopathy.
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Knowledge , Attitude, Practice Survey
Materials and media development
Communication Strategies
Awareness creation
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HOARDINGS
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PBMA’S H.V.DESAI EYE HOSPITAL
EXHIBITIONS
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POSTER ON PUBLIC TRANSPORT
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Rally on world diabetes day
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GROUP MEETINGS-CORPORATES
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ONE TO ONE COUNCELLING
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Screening Services• Training a team(clinical and programme)• Equipments procured• Opportunistic and organized screening
activities- diabetic clinic and camps were arranged• Protocols developed• Data collection and analysis
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Diabetic Clinic - HBP training
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Outreach Camp
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Community Paramedics Doctors
Knowledge about DR 46.8 % 76.3 % 95 %
Knowledge about Risk of DR 0.4 % 49.5 % 92.5 %
Knowledge about Treatment of DR 2.5 % 68.8 % 57 %
KAP survey
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Analysis of effective communication strategy
Media Responses %
Mass media 35 36.10%
Papers-advertisement 28 28.90%
Pamphlets 1 1%
T.V. 5 5.10%
One to one publicity 28 28.90%
97
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Opportunistic screening :Diabetic Clinic
Year 2009 2010 2011
DM 1914 2935 3697
DR 490 (26.2%) 523 (18.5%) 407(11%)
Sight threatening
DR 255 (13.6%) 281(10%) 189 (5.9%)
DR examination cost /patient Rs.64.19
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Organized screening-Camps No of
camps Total DM DR Sight
Threat-ening
DR
Eye camps –Cataract 109 8246 907
(11%) 151
(16.6%)56
(6.17%)
Health checkup camps including eye 375 18757 1149
(6.1%)145
(12.6%)27
(2.3%)
DR campsCommunity supported
8 654 169 (25.8%)
37 (21.9 %)
13(7.7%)
DR campsPhysician supported
61 2068 2068(100%)
341(16.5%)
70(3.4%)
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Treatment
Total LASER VR Anti-VEGF
2009 584 463(79.28%)
43(7.36%)
78(13.36 %)
2010 658 516(78.42 %)
54(8.21 %)
88(13.37%)
2011 625 413(66.08%)
103(16.48%)
109(17.44%)
Total 2492 1867 249 278
Laser treatment cost /sitting /patient Rs.1001.82
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Compliance to Treatment Total pt 84
Treatment completed 40 (47.6 %)
Treatment not completed
44 (52.4 %)
Laser treatment not completed
25 (56.8 %)
PPV and Intrvitreal injection not completed
19 (43.2 %)
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Undiagnosed DR Networking
DR screening services at various levels Awareness creation ,
Media campaign Networking with Physicians
,NGO working for DM
Complex treatment Team Approach Capacity building – support of Lab
and Physician
Poor compliance to treatment Counseling Dedicated counselor-good
documentation
Low level of Awareness
Health Education
Awareness campaign – Dedicated personnel
Unaffordable cost To subsidies Cross subsidize
Lessons learned
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Acknowledgment
• Dr.G V Rao ,Mehnaz Riaz–ORBIS India• Dr.Pravin Narwadkar-Project manager• Mr.Vishnu Gaikwad• Mr.Jitesh Kharat• All the doctors and staff of H.V.Desai Eye
Hospital
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Lions’s Juhu Community Ophthalmology InstitutePBMA’s H.V.Desai Eye Hospital
93 Tarwade vasti,Mohammadwadi,HadapsarPune-411060
[email protected] - + 91 20 26970043 +91 20 26970144