Abstract
Purpose :
“Very often I'm getting gritty and sore, I can't sleep honestly because the irritation is there all the time.” Post-injection pain can negatively impact patient recovery; however, no studies have predominantly examined patient experience following an intravitreal injection nor provided insight into the treatment compliance. This study reports findings from a qualitative perspective incorporating the views of patients and practitioners.
Methods :
This exploratory qualitative study used individual, semi-structured interviews. Following purposive sampling and until saturation was reached, 14 patients with age-related macular degeneration undergoing anti-vascular endothelial growth factor (anti-VEGF) treatment and 7 practitioners were recruited from a hospital eye clinic in Wales, UK. Topic guides comprised of open-ended questions, allowed participants to expand on their personal experiences and to explore specific themes in more depth. Interview transcripts were analysed thematically with an inductive approach, using NVivo 12 (QSR International, UK). The research team reached consensus on the key themes that emerged.
Results :
Six main themes emerged from the data: 1) patients’ fear of losing eyesight over apprehension; 2) variability of pain perception during treatment; 3) post-injection experience and impact on wellbeing; 4) recognising treatment benefits and compliance; 5) quality of care delivery in relation to practice performance and individual needs; 6) strategies to improve patient experience. Patients reported dull-aching and sharp pain, contrary to practitioners’ perspective of feeling a pressure during injection. Headache and sleep disturbance were incidences reported, not previously described in the literature. Despite anticipated pain, patients recognised injections as their only option to preserve eyesight and expressed their willingness to continue treatment. Effective communication and evaluation of performance can improve patient experience.
Conclusions :
This qualitative study identified factors that can influence patient experience before, during and after treatment. Gaining both patients’ and practitioners’ perspectives provided a better understanding of the influence of practitioners’ behaviours on patient experience. Patient follow-up feedback on the intravitreal injection may inform recommendation for practice to measure patient experience more effectively.
This is a 2020 ARVO Annual Meeting abstract.