Current and possible screening practices for diabetic retinopathy by general practitioners: new evidence from a pilot survey of Oxfordshire general practitioners

To investigate the relationship between the number of general practitioners in a GP practice and screening for diabetic retinopathy in order to evaluate the viability of increased GP involvement in screening for blinding diabetic eye disease.

A ten point questionnaire was developed and sent to 50 randomly selected general practitioner practices throughout Oxfordshire. 41 (82%) of the general practitioner practices returned completed questionnaires.

The mean number of GP's per GP practice was 4, with a standard deviation of 4 GP's while GP practice sizes ranged from 1 to 9 GP's per practice. Overall, 66% (n = 27) of GP practices indicated that they referred their diabetic patients for screening, even though 83% (n = 34) of GP practices performed funduscopy. 76% (n = 31) of GP practices ran diabetic clinics, and 66% (n = 27) of GP practices indicated that they wanted more training in the use of the ophthalmoscope and detecting diabetic retinopathy, despite the fact that 78% (n = 32) of this same group had received some form of postgraduate medical training in diabetes in the last five years. Lastly, only 27% (n = 11) of GP practices would alter their attitude to screening for diabetic retinopathy if they were paid substantially more to do so.

Most GP practices referred their diabetic patients for screening, even though the majority of GP practices performed some form of funduscopy and that amongst the largest GP practice sizes all performed dilated funduscopy and did not refer for screening. Given sufficient remedial training in the use of the ophthalmoscope and practical sessions on detecting diabetic retinopathy, it is likely that smaller GP practice sizes would be encouraged to screen for sight-threatening diabetic retinopathy.