United States comparative costs and absenteeism of diabetic ophthalmic conditions

Brook, Richard A.; Kleinman, Nathan L.; Patel, Sunil; Smeeding, Jim; Beren, IA; Turpcu, Adam

doi:10.1080/00325481.2014.994468

Cited by 21 publications

(19 citation statements)

References 16 publications

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“…A study of US employees aged 18–64 years with DR found that the subgroup who had a DME diagnosis cost their employers 75% more than the subgroup who did not have a DME diagnosis (annual direct health care plus indirect work loss costs of $28,606 vs $16,363 in 2005 USD, P <0.0001) 23. High cost and resource use trends (with varying degrees of statistical significance) were also reported for DME in two parallel analyses of US commercial drivers and nondriver employees: drivers with DME and nondrivers with DME had higher costs (annual health care costs of $12,511 and $17,433 in 2012 USD, respectively) than their diabetic controls without DME ($8,785 and $10,926, respectively), missed more work days (27 and 14 days, respectively) than their diabetic controls without DME (15 and 9 days, respectively), and were more likely to use health benefits across a range of services (medical care, prescriptions, sick leave, disability, and workers’ compensation) than their respective control groups 16. In the current study, working-age diabetic patients with DME also utilized more health care resources in terms of both the proportions of patients utilizing services and the mean number of visit days by utilizers than the matched non-DME patients.…”

Section: Discussionmentioning

confidence: 95%

“…Although DME can affect adults of any age, its implications may be different among different age segments. Working-age adults with DME may suffer most due to loss of work productivity and employment stability,16 while elderly patients may have increased caregiver needs and social isolation due to DME 17. Underlying risks of associated diabetes-related comorbidities may also differ by age.…”

Section: Introductionmentioning

confidence: 99%

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Comorbidity and health care visit burden in working-age commercially insured patients with diabetic macular edema

Kiss

Chandwani²,

Cole³

et al. 2016

OPTH

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PurposeTo examine the comorbidity profile and update estimates of health care resource utilization for commercially insured, working-age adults with diabetic macular edema (DME) relative to a matched comparison group of diabetic adults without DME. Additional comparisons were made in the subgroup of pseudophakic patients.Patients and methodsA retrospective matched-cohort study of commercially insured diabetic adults aged 18–63 years was conducted using medical and outpatient pharmacy claims (July 1, 2008–June 30, 2013). Outcomes included diabetes-related and ocular comorbidities and health care resource utilization (any health care visit days, outpatient visit days, inpatient visit days, emergency room visits, eye care-related visit days, unique medications) in the 12-month post-index period.ResultsAll diabetes-related and ocular comorbidities were significantly more prevalent in DME cases versus non-DME controls (P<0.05). A significantly greater proportion of DME cases utilized eye care-related visits compared with non-DME controls (P<0.001). DME cases had almost twice the mean number of total health care visit days compared to non-DME controls (28.6 vs 16.9 days, P<0.001), with a minority of visit days being eye care-related (mean 5.1 vs 1.5 days, P<0.001). Similar trends were observed in pseudophakic cohorts.ConclusionThis working-age DME population experienced a mean of 29 health care visit days per year. Eye care-related visit days were a minority of the overall visit burden (mean 5 days) emphasizing the trade-offs DME patients face between managing DME and their overall diabetic disease. Insights into the complex comorbidity profile and health care needs of diabetic patients with DME will better inform treatment decisions and help optimize disease management.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Comorbidity and health care visit burden in working-age commercially insured patients with diabetic macular edema

Kiss

Chandwani²,

Cole³

et al. 2016

OPTH

View full text Add to dashboard Cite

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“…Psychosocial and socioeconomic factors we looked into did not reveal any meaningful correlation as well. Patients' profession and measured quality of life have been shown to affect patient adherence to treatment in previous studies nevertheless, [64][65][66][67] with vision loss due to DME producing a significant socioeconomic strain on communities. 68 Stress, discomfort, and fear from possible side effects have been shown to have an effect on compliance.…”

Section: Discussionmentioning

confidence: 99%

<p>Factors Affecting Compliance to Anti-Vascular Endothelial Growth Factor Treatment of Diabetic Macular Edema in a Cohort of Jordanian Patients</p>

Abu-Yaghi¹,

Abed²,

Khlaifat³

et al. 2020

OPTH

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Purpose: To determine compliance rates and characteristics and to investigate factors affecting patients' adherence to treatment with anti-vascular endothelial growth factors (anti-VEGFs) for diabetic macular edema (DME) in a cohort of Jordanian patients. Methods: A retrospective case series wherein the files of DME patients treated with anti-VEGFs were reviewed and analyzed for factors affecting treatment compliance was undertaken. Demographic, clinical and ocular characteristics were recorded. All patients were also interviewed by phone using a structured questionnaire. Univariate and multivariate analyses were performed to determine factors associated with compliance. Results: A total of 117 patients (65 males 52 females) were included in this study with a mean age of 62.93 years (±9.75). Approximately, 85% of patients were compliant to their treatment and follow-up plan during the first year of management. Subjective perception of visual improvement after receiving three loading doses was the only independent variable with a unique statistically significant contribution to compliance. All other studied factors in this group of patients were not significantly associated with patient compliance. Conclusion: VEGF suppression via the intravitreal route to treat DME is a long-term process that requires caregiver dedication but also proper patient compliance. Addressing real-life barriers in those patients may help guide future strategies to improve the treatment experience, lower the financial burden and contribute to better outcomes. Patients' perceptions of possible treatment outcomes at the short term may influence their long-term commitment to therapy.

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“…[ 8 ] DME treatment is associated with substantial direct medical costs for the patient, absenteeism for working patients and need for carer’s assistance for injection appointments. [ 8 , 9 ] Moreover, patients report anxiety and high expectations that lead to negative impact on long term anti-VEGF therapy and cause some delay in schedule a new appointment for intravitreal injection. Results from real-life studies are not comparable with the data known from randomized control trials, revealing that the actual number of anti-VEGF injections administered and the proportion of patients achieving significant BCVA gain are lower.…”

Section: Introductionmentioning

confidence: 99%

Biomarkers and predictors for functional and anatomic outcomes for small gauge pars plana vitrectomy and peeling of the internal limiting membrane in naïve diabetic macular edema: The VITAL Study

Iglicki

Lavaque²,

Ozimek

et al. 2018

PLoS ONE

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PurposeWe aimed to investigate biomarkers and predictive factors for visual and anatomical outcome in patients with naïve diabetic macular edema (DME) who underwent small gauge pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling as a first line treatment.DesignMulticenter, retrospective, interventional study.Participants120 eyes from 120 patients with naïve DME treated with PPV and ILM peeling with a follow up of 24 months.MethodsChange in baseline best corrected visual acuity (BCVA) and central subfoveal thickness (CST) 1, 6, 12 and 24 months after surgery. Predictive value of baseline BCVA, CST, optical coherence tomography (OCT) features (presence of subretinal fluid (SRF) and photoreceptor damage), and time between DME diagnosis and surgery. Additional treatment for DME needed. Intra- and post-operative complications (cataract rate formation, increased intraocular pressure).Main outcome measuresThe correlation between baseline characteristics and BCVA response (mean change from baseline; categorized improvement ≥5 or ≥10; Early Treatment Diabetic Retinopathy Study (ETDRS) letters) 12 and 24 months after surgery.ResultsMean BCVA was 0.66 ± 0.14 logMAR, 0.52 ± 0.21 logMAR, and 0.53 ± 0.21 logMAR (p<0.001) at baseline, 12 and 24 months, respectively. Shorter time from DME diagnosis until PPV (OR: 0.98, 95% CI: 0.97–0.99, p<0.001) was a predictor for good functional treatment response (area under the curve 0.828). For every day PPV is postponed, the patient’s chances to gain ≥5 letters at 24 months decrease by 1.8%.Presence of SRF was identified as an anatomical predictor of a better visual outcome, (OR: 6.29, 95% CI: 1.16–34.08, p = 0.033). Safety profile was acceptable.ConclusionsOur results reveal a significant functional and anatomical improvement of DME 24 months after primary PPV, without the need for additional treatment. Early surgical intervention and presence of SRF predict good visual outcome. These biomarkers should be considered when treatment is chosen.

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United States comparative costs and absenteeism of diabetic ophthalmic conditions

Cited by 21 publications

References 16 publications

Comorbidity and health care visit burden in working-age commercially insured patients with diabetic macular edema

Comorbidity and health care visit burden in working-age commercially insured patients with diabetic macular edema

<p>Factors Affecting Compliance to Anti-Vascular Endothelial Growth Factor Treatment of Diabetic Macular Edema in a Cohort of Jordanian Patients</p>

Biomarkers and predictors for functional and anatomic outcomes for small gauge pars plana vitrectomy and peeling of the internal limiting membrane in naïve diabetic macular edema: The VITAL Study

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