SOCIODEMOGRAPHIC FACTORS AS PREDICTORS OF DIABETIC RETINOPATHY SCREENING: A Systematic Review

This systematic review investigates how sociodemographic factors influence diabetic retinopathy (DR) screening adherence among individuals with diabetes. The review examines individuals with diabetes as the target population, focusing on the impact of various sociodemographic exposures on DR screening uptake.

A comprehensive systematic search was conducted across Ovid MEDLINE, Embase, and the Cochrane Library from inception to November 2024. The primary outcome was the overall rate of DR screening among individuals, while secondary outcomes included the odds ratios or proportions of individuals screened for DR, stratified by sociodemographic factors.

Thirty-three studies were included, spanning more than 100,000 participants. Older age, higher education, higher income, and private insurance were consistently associated with higher screening adherence. Employed individuals, particularly those in manual labor or with rigid schedules, had lower participation. Women generally showed higher adherence, although findings varied. Ethnic disparities were observed, with Black and Hispanic populations demonstrating lower screening rates. Geographic distance and travel burden were frequently reported barriers.

This review demonstrates that sociodemographic factors significantly affect DR screening adherence. Strengths include the broad geographic scope and diversity of populations studied. Limitations involve study heterogeneity and occasional reliance on self-reported data.