Abstract
Purpose :
There is limited literature on the barriers to care in neovascular age-related macular degeneration (nAMD). Further, it appears that no studies have globally analyzed barriers to patient care in nAMD outside of North America and Europe, nor have other studies gained perspective from physicians on how to best improve nAMD treatment adherence. We conducted a survey to assess the types of barriers across regions and healthcare systems from the retina specialist's perspective, providing insights for global improvements in nAMD care delivery.
Methods :
We administered a 13-item online questionnaire to retina specialists with a minimum of 5 years of clinical experience and at least one publication on AMD in the past 5 years. Specialists from 29 countries across 5 continents participated, and physician demographics and practice-specific data were collected. Respondents were asked to choose the most prominent barriers to nAMD care among 23 options and the most effective ways to improve treatment adherence among 6 options based on prior research, with an option to report “other” if an answer was not listed.
Results :
The response rate was 44% (180 out of 412). The most prominent barrier to care among all country representatives was the cost of treatment (n=114, 63.7%), and the second most prominent barrier was the frequency of in-person treatments (n=88, 49.2%). Continent-specific, the most prominent barrier in Asia and South America was the cost of treatment (n=60, 90.9% and n=25, 73.5%, respectively). In North America, it was the frequency of in-person visits (n=33, 66.0%). In Europe, there was a tie between the frequency of in-person visits (n=15, 53.6%) and older age (n=15, 53.6%). The most effective way to improve adherence and access to treatment, as identified by the surveyed retina specialists, would be through the development of new treatments that require fewer injections of anti-VEGF (n=154, 86%).
Conclusions :
Several of the reported barriers to care, particularly the cost of treatment and frequency of in-person visits, are shared by nAMD patients globally. Based on our findings, future research that aims to develop a treatment regimen for nAMD requiring fewer in-person injections may have profound international implications in boosting access and adherence to nAMD treatment.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.