Abstract
Purpose :
Geographic Atrophy (GA) remains a significant unmet need, responsible for one-quarter of legal blindness in the UK and around 5 million people affected in at least one eye globally. New therapies administered by intravitreal injection are in late-stage development. These can slow down, but not stop or reverse, GA progression. The patient acceptability of these emerging GA treatments is unknown. This study aimed to: determine patient acceptability; identify attributes of these treatments that patients find less acceptable; and explore demographic and clinical factors that influence acceptability
Methods :
A mixed-methods qualitative study conducted in a retina clinic in London, UK. 30 participants with GA responded to a structured questionnaire and open-ended questions in an interview. A discrete choice experiment (DCE)-style exercise was also conducted to evaluate how participants weigh up benefits and drawbacks of different treatment regimens.
Results :
Of 30 participants, 20 (67%) were female, 19 (63%) were White and the mean (SD) age at interview was 83 (6). 37% of participants had centre-involving GA and mean visual acuity in the better eye was 0.38 LogMAR.
18 of 30 participants (60% (95% CI: 41-79%)) would accept the treatment at any cost, despite potential drawbacks. 8 (27% (95% CI: 10-43%)) were ambivalent about treatment, and 4 (13%) (95% CI: 0-26%)) would be unlikely to accept treatment. Participants with worse self-reported health (higher EQ5D score) were more likely to accept the treatment (rs (28)=0.42, p = 0.021). Reducing the frequency of injections from monthly to every other month resulted in a sharp increase in acceptability. Structured analysis of qualitative data with quotes will be presented. Twenty-eight participants took part in the DCE-style exercise and confirmed participants were generally in favour of less frequent treatment for GA and would trade-off some efficacy to receive less injections and reduce risk of developing wet AMD. Factors limiting acceptability were perceived limited magnitude of treatment efficacy, increased risk of neovascular AMD, and logistical burden of regular clinic visits for injections.
Conclusions :
A majority of participants are positive about intravitreal treatment for GA despite potential drawbacks. This information, to be confirmed in a larger study, will provide insights to optimise service design, delivery and ongoing treatment development.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.