Abstract
Purpose :
The clinical outcome of many retinal diseases relies on patient adherence to repeated intravitreal injections (IVI). The QUALITII survey is a validated survey to quantitatively assess the burden experienced by patients receiving IVI, focusing on a subset of 9 Likert scale items known as the Treatment Burden Score (TBS). We use the QUALITII survey to characterize the treatment burden reported by patients receiving IVI at an academic institution.
Methods :
The TBS survey is administered to patients at an academic institution on a voluntary basis. Inclusion criteria include patients having received at least one IVI.
Results :
Eighty-eight patients (n=50 AMD; n=17 DME/DR, n=14 RVO, and n=7 Other) were surveyed, 55% were female with an average age of 74 years. The mean TBS was 18.6 (range 1-40). The TBS was higher for patients under 70 years old (22.1) compared to patients over 80 years old (15.6) (p= 0.01). Patients under 70 years old reported higher level of pain (2.2, range 0-6,), longer duration of pain (5.4, range 0-6,), and higher anxiety level before treatment (2.3, range 0-6,) compared to patients over 80 years old (1.1, 2.6, 1.6; p= 0.02, 0.003, 0.02 respectively). Prior to injection, 59% reported receiving topical anesthetic while 41% reported receiving lidocaine pledget. The TBS was higher in patients receiving lidocaine pledget (21.9) compared to patients receiving topical anesthetic (17.0) (p= 0.01). Patients receiving lidocaine pledget also reported longer duration of pain (4.9) and higher treatment anxiety (2.7) than patients receiving topical anesthetic (3.9, 1.7; p= 0.05, 0.04 respectively). There was no significant difference in TBS on analysis by gender, race, type of insurance, frequency of injections, or number of total injections received. The overall satisfaction with treatment remained high (4.8, range 0-6, 6=most satisfied).
Conclusions :
The mean TBS was higher at an academic institution compared to a prior study of four private practices which found a mean TBS of 16.1. Younger patients reported higher burden. Patients receiving lidocaine pledget reported higher burden and prolonged pain compared to patients receiving topical anesthetic. Supporting younger patients during the initial treatment phase and offering patients a choice in anesthetic options may improve patient adherence and clinical outcomes.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.