Diabetic retinopathy (DR) is a preventable complication of diabetes with early detection and intervention. Prior studies have shown patient engagement and empowerment improve patient knowledge and self-care resulting in better outcomes. Yet, screening and treatment of DR remain a major challenge especially in our underserved, indigent patient populations. Graphic education material is often used to improve detection of DR but its effectiveness is rarely assessed, especially in the underserved. To improve DR screening in our population, we developed a quality improvement project using in-clinic graphic material to empower patients to screen for DR, followed by post clinic surveys to evaluate the impacts on screening rates and patient engagement.

Posters in English and Spanish were placed in primary care clinics directly viewed by patients for 3 months. We surveyed 100 patients and 12 providers to evaluate the effectiveness of the intervention. We reviewed 84 and 200 charts to determine both pre- and post-intervention DR screening rates.

No difference was seen in the DR screening rate between the pre- and post-intervention periods (51.0% vs. 50.0%, p = 0.86). There were improvements in the referral rate and the retinal exam visit rate between pre- and post-intervention periods (76.2% vs. 82.2%, p = 0.142; 63.9% vs. 73.3%, p = 0.046, respectively). Among the 49 patients who saw educational posters, 69.4% reported the posters prompted them to discuss with the providers about retinal screening exams.

Our study demonstrated that posters can improve patients’ awareness of DR leading to positive engagement with their providers, and eventually improve DR screening efforts. However, multiple factors such as patient literacy, limited encounter time, and understanding may limit the effectiveness of education interventions particularly in our underserved patients. As DR particularly impacts this population, more innovative and direct interactions may need to be implemented to improve self knowledge and patient empowerment to improve DR screening.


A.J. Yang: None. V.T. La: None. C.U. Eke: None. A. Firek: None.

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