Quantifying Patient Preferences and Expectations About Diabetic Retinopathy Monitoring

Area of Science:

• Ophthalmology
• Public Health
• Health Behavior Research

Background:

• Diabetic retinopathy (DR) is a leading cause of blindness in the US.
• Annual DR monitoring is recommended for individuals with diabetes, but adherence is below 70%.

Purpose of the Study:

• To evaluate the association between patient preferences and expectations regarding DR monitoring and their expected adherence behaviors.
• To understand patient values for DR risk reduction versus monitoring costs and time.

Main Methods:

• A web-enabled survey with a discrete-choice experiment and graded-pair questions was used.
• The study involved 304 adults with self-reported, physician-diagnosed diabetes recruited via ResearchMatch.
• Patient preferences for blindness risk reduction, monitoring time, and costs were quantified.

Main Results:

• Participants valued blindness risk reduction but expected DR monitoring to yield smaller risk reductions than required for full adherence.
• A 3.87% reduction in 5-year blindness risk was needed for full adherence, versus an expected 0.71% reduction.
• Results suggest a disconnect between patient-valued outcomes and perceived monitoring benefits.

Conclusions:

• Patient preferences and expectations regarding DR monitoring are linked to nonadherence.
• Insights from this study can inform strategies to improve DR monitoring consistency in diabetic populations.
• Addressing the gap between perceived and actual benefits of DR monitoring is crucial for preventing vision loss.