Abstract
Purpose :
Currently, there is limited knowledge on barriers to care in neovascular age-related macular degeneration (nAMD) and their impact on patients, particularly in the United States. While regular anti-VEGF injections have been proven to preserve and improve vision, this regimen can be difficult to adhere to, thus creating disparities in eye care. We performed a retrospective, observational clinical study to assess how sociodemographic factors affect visit adherence for patients with nAMD.
Methods :
Data from a large healthcare system was analyzed. 962 patients aged 18 and above, who were seen in 2018-2022, and with nAMD in at least one eye were included. Demographic and encounter data were collected from the electronic medical records. The mean number of days between visits and the distance from home to the preferred treatment center were measured. Neighborhoods were ranked by socioeconomic disadvantage using the Area Deprivation Index (ADI). A Mann-Whitney U test was used to assess relationships between demographic variables and mean number of days. Pearson correlation coefficient was used to assess relationships between ADI rank and distance and ADI rank and mean number of days between visits. Significance was set at p ≤ 0.05.
Results :
Insurance type, social deprivation level, marital status, and race significantly influenced the mean number of days between clinic visits. Those with Medicaid or Medicare (70.38 days, n=762) had a higher mean number of days (p=0.007) than those with private insurance (62.78 days, n=85) or who paid out of pocket (64.09 days, n=101). ADI rank was weakly positively, but significantly, correlated with the mean number of days (r=0.08, p=0.012) and distance from home to treatment center (r=0.24, p=0.00). Married individuals (66.27 days, n=460) had a lower number of days (p=0.035) than non-married (68.49 days, n=469). Though low in numbers among study participants, Black (105.03 days, n=14) and Asian (91.94 days, n=18) patients had a higher mean number of days between visits (p=0.002) than White patients (67.05 days, n=909).
Conclusions :
Several sociodemographic factors including insurance type, social deprivation, marital status, and race significantly impacted visit adherence for nAMD patients. These findings offer insight into how we can improve adherence and outcomes for patients with this debilitating eye disease.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.