{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T04:51:24Z","timestamp":1791521484340,"version":"4.3.4"},"reference-count":35,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100001818","name":"Research to Prevent Blindness","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001818","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005242","name":"Heed Ophthalmic Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005242","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Care Science"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Proliferative diabetic retinopathy carries significant visual morbidity and loss to follow\u2010up can lead to poorer visual outcomes. This study aims to evaluate the short\u2010term impact of two systems\u2010focused clinical initiatives directed toward reducing loss\u2010to\u2010follow\u2010up and increasing pan\u2010retinal photocoagulation (PRP) rates in patients with active proliferative diabetic retinopathy (PDR) in an urban, safety\u2010net, teaching\u2010hospital setting. The introduction of an additional weekly PRP clinic was followed by the creation of an active PDR patient registry with an appointment reminder system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a single\u2010center, observational, retrospective cohort study between December 2022 and May 2024. We established three cohorts of encounters based on the number of eyes with active PDR in sequential order: historical controls (115 encounters) in the 8 months preceding the first intervention, increased provider PRP volume (74 encounters) over the next 4 months, and patient registry with an appointment reminder system in addition to increased provider PRP volume (65 encounters) for the following 4 months. We used linear and generalized linear mixed\u2010effects models clustered at the patient level. Short\u2010term process measures included the number of monthly PRP clinics, time to PRP after referral, rates of PRP and full PRP, PRP clinic adherence rate, 3\u2010month ophthalmology clinic adherence rate, and 3\u2010month loss\u2010to\u2010follow\u2010up rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The introduction of an additional weekly PRP clinic was associated with a decrease in time from referral to PRP by 37 days (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), increased odds of 3\u2010month PRP (odds ratio [OR]: 6.53; 95% confidence interval [CI]: 3.03\u201314.10;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and 3\u2010month full PRP (OR: 4.66; 95% CI: 2.22\u20139.78;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Subsequent introduction of a patient registry\/appointment reminder system was associated with decreased odds of 3\u2010month loss\u2010to\u2010follow\u2010up (OR: 0.10; 95% CI: 0.01\u20130.79;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) compared to historical cohort and improved odds of 3\u2010month ophthalmology clinic adherence (OR: 2.96; 95% CI: 1.18\u20137.47;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) compared to the increased PRP clinic cohort.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Dedicating additional clinic time for PRP and introducing a high\u2010risk registry and reminder system were associated with improved access to care, reduced loss\u2010to\u2010follow\u2010up, and increased overall clinic adherence in an urban, safety\u2010net hospital system. Long\u2010term visual and functional outcomes of these initiatives are an essential area of future study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hcs2.70109","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T04:40:09Z","timestamp":1791520809000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Short\u2010Term Outcomes of Two Interventions for Patients With Active Proliferative Diabetic Retinopathy in an Urban, Safety\u2010Net Hospital"],"prefix":"10.1002","author":[{"given":"Paul S.","family":"Micevych","sequence":"first","affiliation":[{"name":"Department of Ophthalmology University of California, San Francisco San Francisco United States"},{"name":"Department of Ophthalmology Zuckerberg San Francisco General Hospital and Trauma Center San Francisco United States"},{"name":"Department of Ophthalmology &amp; Visual Sciences University of Utah Salt Lake City United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0486-4636","authenticated-orcid":false,"given":"Abu Tahir","family":"Taha","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology University of California, San Francisco San Francisco United States"},{"name":"Department of Ophthalmology Zuckerberg San Francisco General Hospital and Trauma Center San Francisco United States"},{"name":"Department of Ophthalmology &amp; Visual Sciences University of California, Davis Sacramento United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anika","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology University of California, San Francisco San Francisco United States"},{"name":"Department of Ophthalmology Zuckerberg San Francisco General Hospital and Trauma Center San Francisco United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1054-3423","authenticated-orcid":false,"given":"Jay M.","family":"Stewart","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology University of California, San Francisco San Francisco United States"},{"name":"Department of Ophthalmology Zuckerberg San Francisco General Hospital and Trauma Center San Francisco United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc15-2171"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2025.109149"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-025-04374-w"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/09286580802435179"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31193-5"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2025.112379"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.4103\/tjo.tjo-d-23-00108"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/aos.14482"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oret.2023.05.014"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2020.03.023"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2020.03.011"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2018.02.034"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2020.09.051"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.3109\/08820538.2016.1154170"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2025.109178"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oret.2019.01.013"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v067.i01"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.15217"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD012314.pub2"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.2147\/OPTH.S73272"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1167\/tvst.12.9.8"},{"key":"e_1_2_13_23_1","unstructured":"J.Wertheimer \u201cNew Billing Policies at ZSFG (April 16 2019) \u201d Zuckerberg San Francisco General accessed August 8 2024 https:\/\/zuckerbergsanfranciscogeneral.org\/news\/new-billing-policies-zsfg-april-16-2019\/."},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1167\/tvst.13.2.12"},{"key":"e_1_2_13_25_1","unstructured":"Y. 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