Treatment contentment and preference of patients undergoing intravitreal anti-VEGF therapy

Abstract

The aim of this study is to investigate patients´ treatment preference between the pro re nata (PRN) and treat and extend (T&E) regimens and their feelings and contentment undergoing intravitreal injections (IVI) with anti-vascular endothelial growth factor (anti-VEGF) agents. Methods Six months after the switch of the treatment regimen from PRN to T&E, answers of a 16-item questionnaire of 105 patients under IVI therapy regarding age, sex and treatment preference (T&E or PRN regimen), as well as burden and anxiety resulting from therapy, were evaluated. Analysis of associations between answers of the questionnaire was executed using Pearson's Chi 2 test and Mann-Whitney U test. P values ≤ 0.05 were considered statistically significant. Results Nearly all patients (90.5%) felt well informed about disease and therapy. Comparing treatment regimen, 13.7% thought PRN was better and 23.3% felt T&E was better. The majority considered PRN and T&E to be equal (60.3%). No significant association between treatment regimen and age (p = 0.15), gender (p = 0.35) and duration of IVI therapy (p = 0.42) was seen. The examination results are associated with fear in the majority of patients (53.3%). Fear about the IVI was indicated by 47.6% of individuals and was significantly associated with pain during treatment (p = 0.0003), pain after treatment (p = 0.004) and fear about unfavourable examination results regarding disease activity (p = 7.94 × 10 −7 ). Conclusions Most patients are satisfied with the IVI therapy and the treatment regimen. Fear of the IVI and particularly of unfavourable examination results demonstrate the high treatment burden for patients undergoing anti-VEGF therapy. These aspects should be taken into account by healthcare professionals.

Recent advances in the treatment and delivery system of diabetic retinopathy

“…In this diabetic macular edema study population, high-dose RBZ does not appear to provide additional benefit over 0.5 mg RBZ ( 69 , 70 ). To slow disease progression and to maintain visual acuity, in most cases repeated intravitreal injections have to be applied and frequent visits in ophthalmological centers are necessary ( 71 ). Generally, to some extent, increasing the dose can improve the efficacy, prolong the action time, and increase the injection interval.…”

“…Patients’ compliance and adherence to therapy is crucial for success of treatment, but the unpredictable frequency of visits and administration of IVIs impose a considerable burden on patients. An IVI can be stressful and can generate apprehension of pain and anxiety ( 71 ).…”