April 2009
Volume 50, Issue 13
ARVO Annual Meeting Abstract  |   April 2009
Patient Preferences in the Treatment of Diabetic Retinopathy
Author Affiliations & Notes
  • B. M. Wirostko
    Ophthalmology, Pfizer Inc, New York, New York
  • K. Beusterien MPH
    Oxford Outcomes,, Bethesda, Maryland
  • J. Grinspan BA
    Oxford Outcomes, Bethesda, Maryland
  • T. Ciulla MD
    Midwest Eye Inst,, Indianapolis, Indiana
  • J. Gonder MD
    Ivey Eye Inst,, London, Ontario, Canada
  • A. Pleil PhD
    Ophthalmology, Pfizer, San Diego, California
  • Footnotes
    Commercial Relationships  B.M. Wirostko, Pfizer Inc, E; K. Beusterien MPH, Pfizer, C; J. Grinspan BA, Pfizer, C; T. Ciulla MD, Pfizer,Neovista,Regeneron, Merck, C; J. Gonder MD, Pfizer, C; A. Pleil PhD, Pfizer, E.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science April 2009, Vol.50, 1592. doi:
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    • Get Citation

      B. M. Wirostko, K. Beusterien MPH, J. Grinspan BA, T. Ciulla MD, J. Gonder MD, A. Pleil PhD; Patient Preferences in the Treatment of Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1592.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: : Several treatments exist for diabetic retinopathy (DR), but data are lacking that compare them from a patient perspective. The objective of this study was to elicit patient preferences for various features (attributes) associated with anti-VEGF therapy, focal and scatter laser, and intravitreal steroids.

Methods: : This was a cross-sectional adaptive conjoint survey administered to DR patients at 3 Canadian eye centers. The survey assessed 13 DR treatment attributes including the chance of improving vision (VA), short-term experience, and risks of adverse events (AEs). Each attribute had three descriptive levels (eg. probability of cataract: 0%, 30%, and 54%). Patients indicated preferences in pairwise comparisons. The analysis estimated the relative utilities for each attribute level. These utilities were summed for different target product profiles to determine the most preferred. Sensitivity analyses examined how changes to single or multiple attributes affected preferences.

Results: : The study sample included 161 patients [79 (49%) laser experience only, 5 (3%) injection experience only, 36 (22%) experience with both, and 41 (25%) treatment-naïve]. Patients valued attributes that were directly related to visual functioning, including the chance of improving VA and reduced chances of AEs contributing to further VA loss (eg. cataracts). Least important attributes were those not affecting vision (e.g., administration regimen). These findings translated into higher preferences for the product profile matching anti-VEGF versus the other options (≥ 75% preferred anti-VEGF in each subgroup). When the base case anti-VEGF attributes were changed to reflect least favorable levels, patients favored steroid therapy but not laser. Results did not differ by age, previous cataract experience, or diagnosis with DME versus PDR.

Keywords: diabetic retinopathy • quality of life • clinical (human) or epidemiologic studies: outcomes/complications 

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