Identifying Strategies for Improving Patient Comfort during Intravitreal Injections

Abstract

Purpose: Intravitreal injections are the most widely used method of pharmacological drug delivery for the treatment of many ocular diseases including age-related macular degeneration. This study aims to identify potential strategies for improving patients' experience with these injections. Our goal is to identify factors that may help alleviate stress, discomfort or anxiety patients may experience during the process. Through improving the patients' experience with intravitreal injections, we hope to increased patient treatment compliance and quality of life.

Methods: 128 patients at two separate retina clinics who were receiving or who had previously received an intravitreal injection for treatment of their ocular conditions were given a survey with 10- yes/no questions. Questions prompted patients to indicate their preferences for/or against potential strategies for improving comfort surrounding intravitreal injections. Patient survey responses were stratified by gender, condition and total number of injections ever received.

Results: From the 128 patients surveyed, the following results were indentified as items that could potentially improve general comfort while receiving an intravitreal injection. 51% (n=66) preferred having a technician/staff present (in addition to the physician) during the injection, ~55% (n=70) would prefer a pillow placed under their neck during the injection, 58% (n=75) would like a verbal warning prior to injection and 69% (n=89) preferred having both eyes injected on the same day if needed. Less favorable strategies (defined as those that <50% patients indicated as helpful) included: background music, dim lighting, holding hand, squeezing a stress ball or having a family member/significant other present. When stratified by gender, >50% of both male and female patients preferred having a pillow placed underneath their neck, a verbal warning and having both eyes injected on the same day if needed. Additionally, >50% of females wanted an extra staff/technician present as well as someone to hold their hand during the injection.

Conclusions: More than half of patients surveyed agreed on the following as effective strategies for improving their comfort during an intravitreal injection: having an extra technician/staff member present during the injection, having a pillow placed under their neck, having a verbal warning prior to injection and having both eyes injected on the same day if needed.