Prabhath Piyasena|Gudlavalleti Venkata Satyanarayana Murthy|Jennifer Yip|Clare Gilbert|Maria Zuurmond|Tünde Pet?|Iris Gordon|Suwin Hewage|Sureshkumar Kamalakannan
Systematic review on barriers and enablers for access to diabetic retinopathy screening services in different income settings
London School of Hygiene & Tropical Medicine|London School of Hygiene & Tropical Medicine|London School of Hygiene & Tropical Medicine|London School of Hygiene & Tropical Medicine|London School of Hygiene & Tropical Medicine|London School of Hygiene & Tropical Medicine|National Hospital of Sri Lanka|Public Health Foundation of India|Institute of Public Health
diabetic retinopathy dr lead visual impairment blindness detected treated time knowing barriersenablers advance contrasting different country income settings may accelerate development successful dr screening drs program would especially applicable lowincome settings rising prevalence drthe aim systematic review identify contrast barriersenablers drs different contexts using consumers ie people diabetes pwdm provider perspectives system level factors different country income settingswe searched medline embase central cochrane library databases start date december 2018 included studies reported barriers enablers access drs services based health care facilities categorised synthesized themes related consumers individuals providers health systems environment main dimensions according constructs social cognitive theory supported quantitative measures ie odds ratios reported study authorswe included 77 studies primarily describing barriers enablers studies high income settings 727 5677 cross sectional design 766 5977 perspectives consumers lack knowledge attitude awareness motivation identified major barriers enablers fear blindness proximity screening facility experiences vision loss concerned eye complications providers perspectives lack skilled human resources training programs infrastructure retinal imaging cost services main barriers higher odds uptake drs services observed pwdm provided health education odds ratio 43 knowledge dr range 13197knowing barriers access drs prerequisite development successful screening program awareness knowledge attitude consumers availability skilled human resources infrastructure emerged major barriers access drs income setting