PT  - JOURNAL ARTICLE
AU  - Marmamula, Srinivas
AU  - Kumbham, Thirupathi Reddy
AU  - Modepalli, Satya Brahmanandam
AU  - Chakrabarti, Subhabrata
AU  - Keeffe, Jill Elizabeth
TI  - Barriers to uptake of referral eye care services among the elderly in residential care: the Hyderabad Ocular Morbidity in Elderly Study (HOMES)
AID  - 10.1136/bjophthalmol-2021-320534
DP  - 2023 Aug 01
TA  - British Journal of Ophthalmology
PG  - 1184--1189
VI  - 107
IP  - 8
4099  - http://bjo.bmj.com/content/107/8/1184.short
4100  - http://bjo.bmj.com/content/107/8/1184.full
SO  - Br J Ophthalmol2023 Aug 01; 107
AB  - Background To report on the barriers to uptake of eye care services after referral in the elderly in ‘homes for the aged’ in Hyderabad, India.Methods Individuals aged ≥60 years were recruited from 41 ‘homes for the aged’ and were examined in the ‘make-shift’ clinics in homes. All participants who had vision impairment or needed further eye examination other than spectacles were referred to the higher centres for ‘free services’. Three months after the referral, the participants were interviewed and asked about the uptake of services, and their reasons for not attending.Results In all, 731/1182 (61.8%) participants were referred of which 375 (49.9%) attended. In multiple logistic regression, participants aged ≥80 years were less likely to utilise the services (OR 0.60; 95% CI 0.39 to 0.03). Similarly, the participants living in free homes (OR 3.53; 95% CI 2.15 to 5.79) and subsidised homes (OR 2.24: 95% CI 1.55 to 3.23) and those independently mobile had higher odds for uptake of services (OR 5.74; 95% CI 3.31 to 10.51). The major reasons for not availing the referral services were ‘lack of felt need’ reported by 136 (45.4%) participants followed by other health issues in 100 (33.4%) participants and non-consenting family members in 49 (16.4%) participants. In all, 14 (4.7%) participants gave other reasons.Conclusions The uptake of eye care services in the elderly in residential care remains poor despite the provision of services for free. Lack of felt need for services is the main reason for non-compliance to the referral for care. Counselling on the benefit of interventions could potentially improve referral compliance in this population.All data relevant to the study are included in the article or uploaded as online supplemental information. Not applicable.