Why communication is the key to diabetes success

A new study recently published in Retina found that communication between a diabetic patient’s eyecare provider (ECP) and primary care physicians (PCPs) increased the likelihood that the patient would make and keep her eye exam appointment.

Researchers at The University of Southern California conducted a retrospective study of 1,968 patients with diabetes who were seen at an urban ophthalmology center. Written communication from an ophthalmologist to a patient’s PCP and communication from a PCP to an ophthalmologist were significantly associated with increased adherence to diabetic eye examinations within the time frame  recommended by the American Academy of Ophthalmology.

Communication in action 

This study is an important development because diabetes patients are notoriously hard to manage when it comes to eye care because they often neglect regular the eye exams necessary to maintain their vision (Mohammad Rafieetary, OD, FAAO, shares one such case HERE).

Related: The importance of multidisciplinary care for diabetes

Optometry Times Editorial Advisory Board member A. Paul Chous, OD, MA, FAAO, regularly lectures on diabetes, and has included this particular study in his presentations since reading about the findings.

“The key message is that diabetes patients are most likely to make and keep appointments for dilated eye examinations when the PCP and/or endocrinologist sends a consult report or request to ophthalmologists," says Dr. Chous. "The effect was positive but less robust when the ophthalmologist sent a report to the PCP/endocrinologist. This underscores the importance of inter-professional communication, especially from the diabetes physician to ECPs.”

Because ODs are increasingly involved in managing systemic disease such as diabetes, communication with a patient’s other healthcare providers is vital to success.

“I think continuous communication among all health care providers is critical,” says Optometry Times Editorial Advisory Board member Diana Shechtman, OD, FAAO. “This is not limited to PCP but may include dentist, podiatry, endocrinology, etc.”

Optometry Times Editorial Advisory Board member Leo Semes, OD, FAAO, says he has seen the positive impact made when a PCP speaks to his diabetic patients about the importance of eye exams.

“During the past couple of years, I have had an increasing number of diabetic patients ask whether they were getting a dilated eye exam, which implies to me that the diabetic doctor-PCP, family practitioner, endocrinologist-has increased awareness of the significance of diabetic eye changes,” he says.

Next: Why ECPs can do better

Why ECPs can do better

With this new evidence that proves how important communication is among healthcare providers, ECPs should make it a priority.

“The pathetic reality, based on people I have spoken with, is that ECPs are doing a woeful job of sending diabetes eye examination reports back to PCPs-something like 10 percent, per the medical director of a large endocrine specialty clinic I spoke with in Phoenix,” says Dr. Chous.

Related: What ODs can learn from managing diabetic patients

Dr. Shechtman says she makes a point to send progress reports to PCPs-even when everything is normal. And she says any signs of diabetic retinopathy should be related back to the PCP because modifying risk factors like HbA1c, blood pressure, and cholesterol levels would impact the development and the progression of diabetic retinopathy.

ECPs should also discuss with PCPs any systemic medications the patient is taking, which may have an impact on the disease.

“By having a number of doctors involve in the patient’s care, it not only increases the patient’s compliance, but it helps with the patient’s overall management,” says Dr. Shechtman.

Dr. Shechtman also recommends that ODs advertise their services to nearby PCPs, which may help to increase referrals.

Related: What’s new for diabetes prevention and management

While not a diabetic, Dr. Semes notes that his own PCP, who is also a patient of his, always asks if Dr. Semes if he gets his eyes checked annually.

“So, increasing awareness and enhanced communication are becoming the norm,” he says.