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A. J. Lotery, A. F. Cruess, X. Xu, G. Zlateva, T. F. Goss, T. Knight; Inter-Country Differences in Patients’ Perception of Humanistic Burden of Neovascular Age-Related Macular Degeneration (AMD). Invest. Ophthalmol. Vis. Sci. 2007;48(13):2111.
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Limited research has examined differences in patients’ perception of the burden of AMD across countries. A multi-country, cross-sectional study was conducted to examine by country the burden of bilateral subfoveal, neovascular AMD on patient-reported functioning.
A total of 401 bilateral neovascular AMD patients from retina clinics and 471 elderly non-AMD (control) patients from general medical practices were surveyed in Canada, France, Germany, Spain, and the United Kingdom (UK). Physicians recorded demographic and clinical 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 health resource utilization. We evaluated the impact of AMD on patients’ QOL and functioning using multivariate regression models for each country.
The average ages of AMD patients were similar across countries (76.2-79.6), and the majority (63% -69%) were females. AMD patients consistently reported substantially worse NEI VFQ, HADS, and EQ-5D scale scores than the control subjects after adjusting for age, gender, and co-morbid diseases. However, substantial differences were also observed in AMD patients across countries. The French AMD patients reported the worst vision-related functioning (adjusted mean NEI VFQ overall scale score 12 points [21%] lower than the Spanish AMD patients who had the best functioning) and the most anxiety symptoms on the HADS anxiety scale (2.4 points [39%] higher [worse] than the UK AMD patients who had the least symptoms). German AMD patients reported the most depression symptoms on the HADS depression scale (4.3 points [74%] higher than the Canadian AMD patients who had the least symptoms), but the best general QOL on the EQ-5D (0.13 points [21%] higher than the French AMD patients who had the worst QOL]. Compared to the control group, French AMD patients reported the greatest decrement (57%) in vision-related functioning than in other countries, while German AMD patients reported the least decrements (40%).
We observed a great variation in bilateral AMD patients’ perception of their QOL, vision-related functioning, and anxiety and depression symptoms across countries, even though within each country, AMD patients consistently reported substantially lower QOL than the control patients.
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