Abstract
Purpose :
Intravitreal injection treatment is the standard of care for numerous retinovascular diseases such as diabetic macular edema (DME) and exudative age-related macular degeneration (AMD). Lack of adherence or undertreatment with respect to evidence from clinical trials remains a significant barrier to optimizing real-world outcomes for patients. Contributing factors and strategies to address this are poorly understood. We wish to identify compliance issues with intravitreal anti-VEGF injections treatment.
Methods :
A patient survey analysis from multiple retina centers in Abu Dhabi and Dubai, United Arab Emirates. Included were patients receiving intravitreal anti-VEGF injections for AMD or DME willing to participate in the survey. Exclusion was inability to participate in the survey. The 20-minutes question interview (22 questions) took place in the clinic. Proportions for the whole patient group as well as for AMD and DME groups were calculated.
Results :
The study included 78 patients (females 32%, males 68%) with average age of 57 years. There were 52 patients with DME and 26 patients with AMD. More than 40% of patients had >7 doctor visits in the last year (46% for AMD patients and 40% for DME patients). More than 50% went to “1 specialist” ever since diagnosed followed by “2-3 specialists” for 35% of patients. Lack of clarity, inconvenience, change of job location and doctor trust were reasons for seeking >3 specialists. Vision improvement was the highest factor for treatment discontinuation followed by visit frequency and costs. Patients regarded treatment visits as “Extremely important” especially AMD patients (65%). 45% of patients never missed a visit, particularly AMD patients (54%). Inconvenient timing was the most significant factor for missing visits followed by fear of treatment. Patients regard the clinic location as “Extremely convenient” especially AMD patients (46%). Physician reputation accounts for 65% of reasons for patients’ clinic choice followed by insurance plan and clinic location.
Conclusions :
Vision improvement was the highest factor for treatment discontinuation followed by frequent visits and costs. Inconvenient timing was the most significant factor for missing treatment visits followed by fear of treatment. Physician reputation was a significant reason for patients’ clinic choice followed by insurance plan and clinic location.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.