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Maximilian Weiß, Tina Herold, Ricarda Schumann, Raffael Liegl, Michael Müller, Alexander Babenko, Miriam Rottmann, Johannes Schiefelbein, Siegfried Priglinger, Karsten Ulrich Kortuem; Compliance and adherence of patients with diabetic macular edema to intravitreal Anti-VEGF therapy. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1908.
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To investigate compliance and adherence of patients with diabetic macula edema (DME) towards intravitreal injection therapies and to compare the findings with patients with age-related macular degeneration (AMD) having the same therapy. Furthermore, to investigate possible effects on visual acuity (VA).
We analyzed the compliance of 136 DME patients with a mean age of 64 years (± 14) (women:36%) in the period of 2013-2016 and 109 AMD patients with an average age of 76 years (±11) (59% women) in the period of 2011-2016 retrospectively. For the analyses we were using our smart eye database, from which we also extracted the data. We investigated the suggested appointment date and the date the consultation took finally place. The number of missed appointments was also assessed. Patients who had missed at least one appointment or had one therapy interruption during the last year were called to query the reasons for not showing up. Furthermore, we correlated compliance to factors such as VA and age.
There was a significantly higher non-compliance rate in DME patients compared to AMD patients, in terms of their punctuality (50% of AMD have never been late vs. only 35% of DME patients (p<0,05)), the length of their delay (median of 24 days for AMD patients vs. 29 days for DME patients (p<0,05) and the amount of therapy interruption (22% of AMD patients had at least one interruption vs. 46% of DME patients (p<0,001)). By speaking to patients on the phone we determined that although the main reason for non-compliance in both collectives were comorbidities (30% of the reasons for AMD patients vs. 18% of the DME patients), more DME patients appeared to be indifferent to their therapy (7% of the AMD patients vs. 17% of DME patients).We also noticed that for DME patients in 60% of the cases the VA deteriorated after a therapy termination with a median loss of one line of VA (p<0,05). Furthermore, we observed a negative correlation (r=-.289, p<0,05) regarding the amount of therapy interruptions and the course of VA.
Our study showed the significant difference between DME and AMD patients in terms of compliance. We could point out different reasons like comorbidities or indifference to the therapy for a non-optimal therapy and the effects on the patient’s outcome. Reminding patients at risk a few days in advance could be a cost-efficient method to address this problem.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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