Factors Influencing Diabetic Retinopathy Screening Attendance: Perspectives of People With Type 2 Diabetes and Healthcare Professionals
Gabriela B. Petersen, Bryan Cleal, Jette K. Kristensen, Henrik Vorum, Stine Byberg, Mia V. Fangel, Lene E. JoensenABSTRACT
Rationale
Diabetic retinopathy screening is an established component of effective type 2 diabetes management, yet participation remains suboptimal. Understanding why individuals do not attend screening requires consideration of interactions between patients, healthcare providers, and the organisation of care.
Aim
To explore patient‐, provider‐, and system‐level factors influencing diabetic retinopathy screening attendance within routine type 2 diabetes care, from the perspectives of individuals with type 2 diabetes, general practitioners and eye clinic staff.
Methods
Semi‐structured interviews were conducted with people with type 2 diabetes ( n = 20), general practitioners ( n = 10) and eye clinic staff ( n = 8). Data were analysed using systematic text condensation. Findings were mapped onto the Chronic Care Model to categorize system, provider, and patient‐level components.
Results
Non‐attendance was influenced by multiple interacting factors, including transportation difficulties, limited awareness of diabetic retinopathy and the purpose of screening, competing health priorities, and challenges integrating diabetes care into everyday life. Healthcare professionals identified time constraints, unclear responsibilities, and insufficient communication between primary and specialist care as important organisational barriers. Facilitators included family support, encouragement from healthcare providers, and awareness of the potential consequences of diabetes and untreated diabetic retinopathy.
Conclusions
Non‐attendance at diabetic retinopathy screening is rarely an explicit or informed decision to decline care. Rather, participation is shaped by interacting structural, informational, contextual, and relational factors across the healthcare system. Improving screening attendance requires approaches that extend beyond increasing patient awareness, including systematic support within routine diabetes care, tailored communication, improved coordination between primary and specialist care, and proactive follow‐up strategies.