American Diabetes Association

TABLE 1

Barriers to Recommended DRD Screening

Component	Considerations
Patient-level factors	Lack of education about/understanding of DRD and the availability of treatment Cost/insurance issues Lack of follow-through on referral/recommendation Lack of access to care Patient-provider communication issues (e.g., language barriers, limited health literacy, and lack of trust)
Provider-level factors	Lack of awareness of screening guidelines, skill, or equipment to perform eye exams Patient-provider communication issues (e.g., language barriers, limited health literacy, and lack of trust) Time limitations Inconsistent primary care provider referral patterns
System-level factors	Insurance issues Understaffing of eye care professionals/difficulty obtaining diagnostic imaging Long wait times for appointments

Component	Considerations
Patient-level factors	Lack of education about/understanding of DRD and the availability of treatment Cost/insurance issues Lack of follow-through on referral/recommendation Lack of access to care Patient-provider communication issues (e.g., language barriers, limited health literacy, and lack of trust)
Provider-level factors	Lack of awareness of screening guidelines, skill, or equipment to perform eye exams Patient-provider communication issues (e.g., language barriers, limited health literacy, and lack of trust) Time limitations Inconsistent primary care provider referral patterns
System-level factors	Insurance issues Understaffing of eye care professionals/difficulty obtaining diagnostic imaging Long wait times for appointments

Adapted from ref. 105.