Abstract
Purpose::
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.
Methods::
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.
Results::
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%).
Conclusions::
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.
Clinical Trial::
TBD
Keywords: clinical (human) or epidemiologic studies: health care delivery/economics/manpower • quality of life