(Philadelphia, PA)--The Scheie Eye Institute, in conjunction with the University of Pennsylvania Health System, continues to expand an aggressive and unique recruitment program within the local West Philadelphia community to promote the early detection of "diabetic retinopathy". While ophthalmologists have a treatment that is nearly 100 % effective in preventing this form of blindness, it remains the leading cause of blindness among "working age" adults. "The age distinction is especially critical because diabetic retinopathy can hit patients during their most productive years, whereas age related macular degeneration, glaucoma and cataracts which cause more blindness overall, mainly affects the older generation," notes 4 Sight program Director, Maureen G. Maguire, Ph.D., University of Pennsylvania Health System Professor of Ophthalmology.
The 4 Sight program, the first of its kind in the nation, seeks to recruit diabetics to participate in annual eye examinations as recommended by the American Diabetes Association. People with diabetes are at high risk for vision loss as their condition often leads to blood vessel damage in the retina. Additionally, diabetics have an increased risk for developing glaucoma and cataracts. Many diabetics, however, have no idea they have severe diabetic retinopathy until they have a catastrophic event such as a hemorrhage or a retinal detachment.
The annual examinations become the critical component. Less than half of diabetics who should be getting annual exams do so. It is of added concern that communities with education and lesser income levels have markedly lower examination rates. Annual exams can reveal changes in a patient's eyes that indicate problems necessitating a series of proactive and preventative treatments, depending on the severity of the condition. These measures range from the simple, regular monitoring of one's blood glucose level, where the changes in the eyes have been minor, to laser treatment in more severe cases. "Blindness can be prevented altogether or limited significantly, if the eyes are checked on a regular basis, treated accordingly, and the patients are informed of in advance, as to what warning signals to look for,"said Maguire. This is of special concern to the African-American community where it is estimated that black women are 2.4 times as likely to develop diabetes as white women are.
The 4 Sight program developed a targeted telephone recruitment campaign aimed at high-risk candidates which "is the most personal and cost effective approach" according to Maguire. Previous attempts to target at-risk community members included health fairs, postings at supermarkets and local stores, educational announcements through local ministers as well as mass mailings. "One to one personal discussions by telephone identifying the vision risks associated with diabetes and the advantages of annual examinations, have really had a positive effect on the participation level in our program" noted Maguire. Once the candidate becomes aware of the real benefits of being in the program such as: personal reminders of all required examinations, assistance with transportation, assistance with referrals and payment arrangements, in addition to general information regarding diabetes and local support groups in the community, enrollment becomes much easier. It is hoped that the 4 Sight approach will serve as a model for communities around the country.
Utilizing existing patient databases within the expansive University of Pennsylvania Health System, accurate targeting of diabetic patients has led to a current enrollment in the program of 470 patients. The 4 Sight program hopes to increase its membership to 1,000 by June 2001, stated project director Eveline DiFranco. Further expansion of the 4 Sight program will involve targeting the 40% of patients in dialysis clinics who are diabetic and increasing the presence of diabetic support groups in the neighborhood, the development of which is being led by 4 Sight program case manager, Billie Johnson, RN.
Editor's Note: For more information, please contact the 4 Sight program at the Scheie Eye Institute at 215-615-1554. For patient appointments, please call 215-615-1553.