The Diabetic Retinopathy (DR) Barometer Program is an action network of individuals and organizations working to improve the vision health outcomes of adults with diabetes through collaboration, action and knowledge exchange. This program was first initiated with the ground-breaking 41 country DR Barometer Study.
With a rapidly ageing population, understanding the risks of acquiring an age-related vision health condition is of critical importance. Vision Health Month in May represents an opportunity to join the Canadian conversation regarding the impact of vision health by showcasing key findings from the DR Barometer Study as well as sharing new DR Barometer program developments. The awareness campaign also highlights the importance of education and patient empowerment, as well as equitable access to safe and effective screening and treatment of eye conditions for everyone, but specifically for older people and those most at-risk, or neglected by other mechanisms of health promotion.
Aligned with current global trends it is anticipated that by the year 2040 individuals 65 years or older will make up over a quarter of the Canadian population. The reality of population ageing poses significant challenges, one of which is the increased prevalence of non-communicable disease, specifically diabetes.
Canada has over 2.5 million people living with diabetes, a number of which is only expected to grow in the coming years. The DR Barometer study helped to shed light on the impact of vision related health outcomes for individuals living with diabetes as well as the barriers and factors which contribute to the screening, treatment and management of diabetes related vision complications. While Canadian patients reported relatively high awareness of eye complications there is still a pervasive belief that vision loss is inevitable and that there is no way to prevent it. This is exacerbated by the fact that late diagnosis was noted as one of the most significant barriers to improved vision health outcomes.
The Growing DR Community
Capitalizing on the momentum of the DR Barometer Study two regional workshops were convened in 2018 bringing together diverse stakeholders and representing 18 countries. These attendees included advocates for diabetes, vision health, and older persons, ophthalmologists, diabetes specialists, geriatricians, primary care providers, public health professionals, and industry. The program featured plenary sessions with key opinion leaders focused on regional specific topics including the burden of disease, patient education and empowerment, screening practices, latest treatment options, and the need for a coordinated approach to diabetes care. Interactive breakout sessions facilitated cross-disciplinary dialogue, collaboration, and development of potential strategies to improve patient outcomes.
The DR Barometer Communities of Practice
The findings of the Dr Barometer Study and the outcomes of the two regional workshops ultimately coalesced in the establishment of the three distinct Communities of Practice (CoP). The DR Barometer Program’s three CoPs: Patient Education and Empowerment, Coordinated Care and Guidelines and Protocols, encapsulate the priority areas identified and provide an evidence-based foundation with which to drive meaningful change in the screening, treatment, and prognosis of diabetic retinopathy for adults living with diabetes.
The Patient Education and Empowerment CoP looks to address the lack of knowledge and awareness regarding diabetes relate vision health which were key predictive factors in adherence to vision health care recommendations.
“Education is at the heart of a proactive approach to manage the threat of preventable blindness. The data is quite clear and showed us that the current information is not adequate for patients and in reality, only half of the ophthalmologists in the study had written detection protocols for staff and in some instances, educational material didn’t even exist,” says Dr. Jane Barratt
The Coordinated Care CoP attempts to address the barriers in the coordination and communication of health care services. These gaps and / or disconnections in the patient care pathway can lead to delays in diagnosis, increased likelihood of impaired vision and a decrease in the overall management of the disease.
“All individuals with type 2 diabetes should be screened at the time of diagnosis and regularly thereafter. Helping prevent diabetes related vision loss requires close collaboration between patients and their health-care provider, as well as ensuring all people with diabetes have access to evidence-based screening and treatment,” says Dr. Jan Hux.
Lastly the Guidelines and Protocols CoP addresses the growing need for consistency across healthcare systems as well as an increase in the awareness and uptake of guidelines and protocols by health care professionals. The IFA as secretariat of the DR Barometer Program is excited to announce the upcoming launch of the new DR Barometer website which will feature interactive forums in which individuals can engage with the DR Barometer Community. Join the DR Community and help shift the needle and make real change happen in our health systems and communities, ultimately creating a world where people do not experience vision loss due to diabetes.
Over the last four years, the Eye See You campaign has informed and educated Canadian audiences about the importance of vision health. Evolving out of a growing recognition that, with a nationally ageing population, the prevalence of vision loss in Canada is increasing.
This year, the IFA, on behalf of the Eye See You campaign and in honour of Vision Health Month, is delighted to announce Dispelling Myths Surrounding the Vision Health of Older People, a panel discussion featuring experts on Geriatrics and Vision Health taking place in Toronto, Canada on 28 May 2019. This is a great opportunity to learn about matters related to vision health in a Canadian context. Don’t miss the chance to register.
The Eye See You public awareness campaign aims to encourage discussion amongst Canadians, while increasing awareness on the importance of patient empowerment and physician autonomy. By gathering insights, building awareness and stimulating action on health issues that matter to Canadians, the Eye See You campaign continues to mobilize and advocate for vision health.
In addition to a panel discussion, the Eye See You campaign is pleased to be able to share new information that showcases what Canadians think about vision health. Make sure to follow the IFA on social media to have a firsthand look at these results.
Vision Health Month in May represents an exciting opportunity to build upon the ‘Eye See You’ discussion and further reinforce that vision loss can happen to anyone, at any age. Join Canadians across the country in this important conversation, discussing the many factors that impact vision health and enable healthy ageing.
The Eye See You Campaign ensures that the national conversation this year and every year includes topics including improved patient education, affordable comprehensive screening and treatment and the critical role of a physician to be able to determine the safest, appropriate and most effective treatment for each patient. Treatment decisions are not decisions for government but rather a conversation between the patient and their physician and based on sound scientific evidence to optimise functional outcomes.
Visit eyeseeyou.care to learn more about the work and access vision health resources from Eye See You partners.
Submitted by: The Australian College of Nursing
Australia has a world class, federally funded public health system. The importance of herd immunity and the public health benefits of timely vaccination are recognised and funded through a range of national, state and territory programs. As a result, Australia’s diverse population have access to an age appropriate vaccination schedule, designed to provide immunisation against preventable conditions and additional protection for at risk populations.
The Commonwealth of Australia, Department of Health (2018) lists the range of indications for vaccination as: providing protection against preventable conditions during childhood, catching up on vaccinations missed in childhood, and obtaining the coverage required to reduce the risks associated with traveling to high-risk locations or when working in a high risk occupations, such as health or childcare.
In recent years, strategies aimed at providing additional coverage for at-risk Australian populations, have been announced. In addition to diphtheria, tetanus and whooping cough boosters, vaccination against influenza, herpes zoster and pneumococcal disease, are now free for older adults. People employed in high risk occupations receive a free annual influenza vaccination. Websites such as Smart traveller (administered by the Australian Department of Foreign Affairs and Trade), provide timely advice for consumers and healthcare professionals, seeking vaccination, prior to entering high-risk geographic locations. However, one of Australia’s most vulnerable populations, are our Aboriginal and Torres Strait islander people, who for a range of socio-political reasons, experience vastly inferior health outcomes, as compared to non- Indigenous members of the Australian population.
In 2005, the Aboriginal and Torres Strait Islander Social Justice Commissioner, Professor Tom Calma, released the Social Justice Report which called for Australian governments to commit to ‘achieving equality for Aboriginal and Torres Strait Islander people in the areas of health and life expectancy within 25 years’ (2031). In his foreword to the most recent Closing the Gap Report (2019), Prime Minister Scott Morrison, re-committed to ‘a whole of government agenda with all governments sharing accountability for progress and extending this shared accountability to include Aboriginal and Torres Strait Islander people’.
Australia’s Aboriginal and Torres Strait Islander people comprise approximately 3% of the total population, living and working in variety of urban, rural and remote locations (Australian Bureau of Statistics [ABS] 2018). The most recent census conducted by the ABS in 2016, revealed that the Aboriginal and Torres Strait Islander population had a younger structure than Australia’s non-indigenous population, due to the compounding effects of both higher fertility and higher mortality.
In order to confer additional protection, Aboriginal and Torres Strait Islander babies are eligible for extra vaccinations under the National Immunisation Program. Additional vaccinations for pneumococcal disease, hepatitis A and influenza are available free of charge to babies living in Queensland, Northern Territory, Western Australia and South Australia. In addition to being vaccinated under the National Immunisation Program, all Aboriginal and Torres Strait Islander adolescents and adults, aged 15 years and over, have access to additional free influenza and pneumococcal vaccinations.
In February 2019, the Federal Liberal Health Minister Greg Hunt, launched the National Immunisation Strategy 2019-24 (Hunt 2019). In doing so, Minister Hunt disclosed that, child immunisation rates are at a record high in Australia, adolescent Australians now receive protection against human papilloma virus and meningococcal disease through a school based immunisation programme, expectant mothers have access to a federally funded whooping cough vaccination and all 12 moth old babies now receive free vaccination against meningococcal A, C, W and Y.
Additionally, Minister Hunt announced that 170,000 Aboriginal and Torres Strait Islander children and adolescents will receive free influenza vaccines, and an additional $12 million will be spent on an advertising campaign aimed at raising awareness of the benefits of immunisation.
It is hoped that these new initiatives will facilitate the achievement of the Australian Federal Government’s 95% herd immunity target and advance the health and mortality of all Australians.
Aboriginal and Torres Strait Islander Social Justice Commissioner 2005, Social justice report 2005, Human Rights & Equal Opportunity Commission, Sydney.
Australian Bureau of Statistics [ABS] 2018, Estimates of Aboriginal and Torres Strait Islander Australians, ABS, Canberra, viewed 21 March 2019, https://www.abs.gov.au/ausstats/abs@.nsf/mf/3238.0.55.001
Commonwealth of Australia 2018, Immunisation for adults, Department of Health, Canberra, ACT, viewed 21 March 2019, https://beta.health.gov.au/health-topics/immunisation/immunisation-throughout-life/immunisation-for-adults
Commonwealth of Australia 2019, Closing the Gap Report 2019, Department of the Prime Minister and Cabinet, Canberra, ACT.
Hunt, G 2019, Free flu vaccines for Aboriginal children and $12 million to boost immunisation, Author, Canberra, viewed 21 March 2019, http://www.health.gov.au/internet/ministers/publishing.nsf/Content/health-mediarel-yr2019-hunt022.htm