Barriers to Screening for Diabetic Retinopathy: A Scoping Review

Purpose/Background More than 34 million people in the United States have diabetes. Diabetic retinopathy (DR) is a major complication of diabetes and a leading cause of vision loss. Risk factors for diabetic retinopathy include Type 1 and Type 2 Diabetes, hypertension, smoking, and being African American or Hispanic/Latino. This scoping review seeks to analyze the current research on ways to increase vision screenings, thus reducing cases of diabetic retinopathy in adults. Methods Between September 2020 and November 2021, a search was conducted using PubMed, EBSCOhost, Medline, and CINAHL to identify articles using keywords such as diabetic retinopathy and ophthalmology. This extensive search led our group to twenty articles from different levels of evidence, which after undergoing rapid critical appraisal (RCA) left us with fifteen to be included in this scoping review. Our goal was to understand the barriers to receiving annual screening and strategies to enhance compliance with ophthalmology. Results The articles in our scoping review include systematic reviews, randomized control trials, and case-control studies. From the articles, we discovered barriers to receiving annual exams include cost, insurance, and education. We concluded that patient education along with annual referrals to ophthalmology as prevention for diabetic retinopathy is essential for reducing vision loss. Implications for Nursing Practice Based on our scoping review, we understand that multiple barriers exist that complicate compliance with annual vision screenings. Primary care providers play an essential role in providing patient education and referral to ophthalmology to decrease the prevalence of diabetic retinopathy. More research is needed on the effectiveness of interventions such as educational pamphlets in enhancing screening rates