Cultura

Interprofessional Screening For Diabetic Retinopathy And Medication Adherence: Integrating Pharmacy, Optometry, And Nursing Services In Saudi Primary Care Settings

VOLUME 22, 2025

The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review

VOLUME 6, 2023

Abdulrahman Dalami Kaabi, Mohammed Salem Alrehaili, Khalid Assaf Alotaibi, Abdulaziz Mohammed Alotaibi, Sultan Khalaf Alsaleh, Ghanem Hamdan Maklef Al Shammary, Eshraq Zaal Alshammari

Abstract

Diabetic retinopathy remains a leading cause of preventable vision loss among adults with diabetes mellitus, yet screening adherence and medication compliance persist as critical barriers to effective disease management. This systematic review examines the potential for interprofessional collaboration among pharmacy, optometry, and nursing services to enhance diabetic retinopathy screening and medication adherence in Saudi Arabian primary care settings. A comprehensive search of peer-reviewed literature was conducted to identify evidence-based interventions involving pharmacist-led medication reviews, optometrist-conducted retinal screenings, and nurse-coordinated care models. Findings indicate that team-based approaches significantly improve patient outcomes, increase screening attendance, and enhance medication adherence rates compared to traditional siloed care delivery. Barriers including limited integration of services, workforce constraints, and patient access challenges are identified as impediments to optimal implementation in Saudi Arabia. Evidence supports the feasibility and clinical effectiveness of incorporating community pharmacists, optometrists, and nursing professionals into coordinated diabetes care pathways. This review provides a framework for healthcare policy development aimed at establishing sustainable interprofessional models that address the dual challenges of diabetic retinopathy prevention and medication non-adherence within resource-diverse primary care contexts.

Keywords : diabetic retinopathy screening, medication adherence, interprofessional collaboration, primary care, Saudi Arabia..
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.

Abstract

Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords : Diabetic foot ulcer, angiosome, angioplasty