June 2020
Volume 61, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2020
Barriers and facilitators for e-mental health in patients who receive anti-VEGF treatment: a qualitative study among Dutch secondary care stakeholders
Author Affiliations & Notes
  • Hilde Petronella Adriana van der Aa
    Ophthalmology, Amsterdam UMC, VUmc, Amsterdam, Netherlands
  • Ger HMB van Rens
    Ophthalmology, Amsterdam UMC, VUmc, Amsterdam, Netherlands
    Ophthalmology, Elkerliek hospital, Helmond, Netherlands
  • Ruth M A Van Nispen
    Ophthalmology, Amsterdam UMC, VUmc, Amsterdam, Netherlands
  • Footnotes
    Commercial Relationships   Hilde van der Aa, None; Ger van Rens, None; Ruth Van Nispen, None
  • Footnotes
    Support  ZonMw Doelmatigheid, the Dutch Organisation for Health Research and Development (grant No 80-84300-98-71046
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 1568. doi:
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      Hilde Petronella Adriana van der Aa, Ger HMB van Rens, Ruth M A Van Nispen; Barriers and facilitators for e-mental health in patients who receive anti-VEGF treatment: a qualitative study among Dutch secondary care stakeholders. Invest. Ophthalmol. Vis. Sci. 2020;61(7):1568.

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

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Abstract

Purpose : During anti-VEGF treatment patients are subjected to frequent invasive intravitreal injections while the effects are uncertain; for one in three patients this has negative consequences for their mental health. Therefore, a guided Internet-based self-help course, following the principles of cognitive behavioral therapy (called E-PsEYE), was developed and tested in a large randomized controlled trial (RCT). Patients were referred by their ophthalmologist to follow E-PsEYE individually in their own homes and were guided digitally and by telephone by a social worker from a low vision service. The purpose of this qualitative study was to evaluate barriers and facilitators to use this novel intervention in future Dutch clinical practice.

Methods : Semi-structured interviews were performed with patients (n=8), eye care professionals from three large Dutch hospitals (i.e. heads of ophthalmology departments (n=2), ophthalmologists (n=4) and support staff (n=3)), low vision rehabilitation professionals from two nationally operating low vision services (i.e. managers (n=2), social workers (n=6)) and a health insurer. All interviews were recorded by a digital voice recorder and transcribed verbatim. A thematic approach was used to analyze the data using the conceptual framework of Fleuren et al.

Results : Individual perceptions on e-health, based on (lack of) knowledge and self-efficacy, either impeded or facilitated the use of E-PsEYE in both patients and low vision rehabilitation staff. An important barrier for eye care professionals were lack of time and self-efficacy in addressing patients’ mental health and referring them before the end-stage of the disease. Moreover, the vision loss not meeting WHO criteria in many patients receiving anti-VEGF were expected to result in difficulties to enroll patients in low vision services and to ensure coverage of healthcare costs.

Conclusions : Different barriers and facilitators were found on the individual level and in the interaction between stakeholders and their context. Implementation strategies that focus on these different aspects may optimize the use of E-PsEYE in addressing mental health in patients who receive anti-VEGF treatment. Results of the RCT may additionally shed light on the acceptability of E-PsEYE in the near future regarding its cost-effectiveness from a societal perspective.

This is a 2020 ARVO Annual Meeting abstract.

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