There is limited evidence on effective care models for diabetic retinopathy in Indigenous Australians, so Rosamond Gilden conducted her own study to figure out the best approach.
In Australia, Aboriginal and Torres Strait Islander peoples (hereafter respectfully referred to as Indigenous Australians) are three times more likely to have diabetes than non-Indigenous Australians and have a higher rate of diabetes-related vision impairment (5.5%) compared to their non-Indigenous counterparts (1.5%). Despite this, there has been limited evidence about suitable treatment models or clinical guidelines to provide appropriate and best-practice care to Indigenous Australians.
“There is a need to support additional research on these best-practice features to receive Indigenous-led feedback and new input into care models.”
As part of my six-month Masters of Public Health project conducted in February 2020, I investigated what best-practice features are required to ensure that Indigenous Australians with diabetic retinopathy (DR) have better treatment outcomes.
As the COVID-19 pandemic commenced during the time of my project, I was limited in my research approach and participant options. A practical way forward was to interview ophthalmologists who were regularly providing DR care to Indigenous Australians. A total of eight ophthalmologists were recruited that represented varied geographic settings (urban, regional and remote) and jurisdictions in Australia.
From the interviews, seven best-practice features were identified. These are outlined in table 1.
A limitation of this study was that it did not capture views and perspectives of Aboriginal Medical Service staff and community end-users. Further research is warranted to expand on these findings and include these perpectives.
However, in the meantime, the best-practice features identified in this study have started to address a gap in the research on equity in DR treatment in Australia.
The challenge now for the eye health sector based on this research is therefore two-fold when considering the future of DR treatment in Indigenous communities.
Firstly, there is a need to support additional research on these best-practice features to receive Indigenous-led feedback and new input into care models. Once this is completed, the second challenge is to integrate all of the findings into policy and funding models going forward to ensure a truly accessible and culturally safe DR program of treatment is provided to Indigenous Australians.
This will require collaboration and commitment from all levels of government, advocacy bodies, workforce agencies, Indigenous eye health organisations, research bodies and the peak bodies of Aboriginal and Torrest Strait Islander health.
NOTE: To read the full article, ‘Identifying best-practice features of diabetic retinopathy treatment models for Aboriginal and Torres Strait Islander Australians’, visit: onlinelibrary.wiley.com/doi/full/10.1111/ajr.12949.
About the author: Rosamond Gilden is an Orthoptist and Regional Coordinator for DR-NET, South Pacific Region. DR-NET is a large network of programs delivering DR screening and treatment in low- and middle-income countries. Her role includes coordination, stakeholder engagement, data collection and capacity building for DR in the South Pacific region. She is also a member of DR-NET’s steering committee.
More reading
The Voice to Parliament – what a ‘yes’ vote would mean for Indigenous eye health
AIHW report highlights progress and identifies gaps in Indigenous eye health service
Re-writing the rules of dry eye management
