CROSS-SPECIALTY CARE IN DIABETIC RETINOPATHY : ENDOCRINOLOGY MEETS OPHTHALMOLOGY

The current trial was carried out based on a cross-specialty care paradigm in which ophthalmology and endocrinology specialists collaborated to treat diabetic retinopathy (DR) by using a mixed-methods experimental framework.  Compared to the other group designated to standard care, there were statistically significant changes in the integrated care group in terms of visual acuity (p < 0.01), central macular thickness (p < 0.05), and abatement of glycaemic control (with lower HbA1c levels) through quantitative measures of a cohort (n = 240).  A dramatic reduction in serum VEGF was also noted, and this was also in agreement with stabilisation of retinal disease.  The increased patient satisfaction, more effective treatment compliance, and interdisciplinary communication were all identified in qualitative interviews of patients and physicians within the framework of the integrated paradigm.  Various regression analysis indicated that tight glycaemic control, early ophthalmologic intervention and patient adherence were also powerful predictors of visual stabilisation (R2 = 0.68, p < 0.001).  Thematic coding of clinician narratives would bring into focus the value of collaborative consultation processes and the availability of real time data in reducing diagnostic and referral delays.  To achieve these needs, the cooperation of medical specialities was necessary to deal with the systemic and localised disease loads associated with diabetic microvascular issues.  The findings of the study also emphasize the worth of the work of interdisciplinary teams in chronic disease management and establish a model of an integrated care strategy in settings where the resources vary.  The results promote the policy of implementing shared care pathways in diabetic retinopathy clinics all over the world.