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A.F. Cruess, X. Xu, J. Monès, A. Lotery, D. Pauleikhoff, G. Soubrane, G. Zlateva, T.F. Goss; Humanistic Burden and Health Resource Utilization Among Neovascular Age–Related Macular Degeneration (AMD) Patients: Results from a Multi–Country Cross–Sectional Study . Invest. Ophthalmol. Vis. Sci. 2006;47(13):2199.
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This study was undertaken to describe the burden of bilateral subfoveal, neovascular AMD on patient–reported functioning and health resource utilization (HRU) as compared to elderly controls without AMD.
A total of 365 bilateral neovascular AMD patients from retina specialists and 469 elderly non–AMD (control) patients from general practitioners were recruited in Canada, France, Germany, Spain, and the United Kingdom in a cross–sectional, observational study. Physicians recorded demographic and treatment information. Patients completed a telephone survey of the National Eye Institute Visual Function Questionnaire (NEI VFQ–25), the EuroQol (EQ–5D), the Hospital Anxiety and Depression Scale (HADS), and history of falls, fractures and HRU. The impact of AMD on patients’ functioning and HRU was evaluated using chi–square tests, analysis of variance, and multivariate regression models.
The mean (sd) age of AMD patients was 77.9 (6.8) years and 66% were female. The adjusted mean (95% CI) NEI VFQ overall scale scores was 57.6 (55.3, 59.9) in AMD patients, which was substantially worse than the control patients 85.6 [83.6, 87.6] after adjusting for better seeing eye visual acuity, age, gender, and co–morbid diseases (p<0.001). AMD patients reported significantly more anxiety and depression symptoms than control patients on the HADS scales (adjusted mean anxiety scores: 6.4 vs. 5.1, p=0.019; depression scores: 5.8 vs. 4.4, p=0.003) after adjusting for covariates. The impact of AMD was also seen in other health–related problems, such as falls and depression treatment. The proportion of AMD patients who fell in the past 12 months was twice the proportion of control patients (17% vs. 8%, p<0.001), and over half of these patients requested medical treatments. Even though similar proportions of patients were on depression/anxiety treatment in the past 12 months, AMD patients reported significantly longer treatment period than control patients (9.7 vs. 7.9 months, p=0.026).
Bilateral AMD patients reported substantially worse quality of life, poorer vision–related functioning, and more anxiety and depression symptoms compared to a control group of subjects without AMD.
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