5/18/2023 0 Comments Ivi treatmentPrior to answering the questionnaire, patients were informed that their responses were analysed anonymously and with responding to the questionnaire they would agree to this data evaluation. Within the frame of regular quality assessment of medical care in a large outpatient ophthalmologic tertiary centre, patients with exudative macular diseases undergoing intravitreal anti-VEGF treatment were asked to anonymously respond to a 16-item questionnaire regarding age, gender, burden and anxiety associated with the therapeutic process. Treatment regime preference (T&E or PRN) was enquired, if IVI therapy was administered for at least 1 year so that the patient had comprehensive experience with both schedules. To identify ways to improve comfort during therapy, we have analysed patient preference of treatment regimens and patients’ contentment during IVI therapy with anti-VEGF agents. Patient experience is important for adherence to treatment and long-term functional success. Less is known about patient’s experience undergoing anti-VEGF therapy. Most studies focus on morphological and functional outcome parameters and do not include the perception of patients on the treatment strategy so that evidence on this complex topic is limited. An IVI can be stressful and can generate apprehension of pain and anxiety. Patients’ compliance and adherence to therapy is crucial for success of treatment, but the unpredictable duration of frequent visits and IVIs imposes a considerable burden to the patient. Retreatment depends on disease activity defined based on changes of best corrected visual acuity and lesions detectable in optical coherence tomography (OCT) images. Recently, the T&E regimen was assessed to be able to optimize visual outcomes and to reduce burden on patients compared to the PRN regimen. The treatment regimen usually begins with three to six monthly injections as a “loading phase”, mostly followed by an individualized treatment regimen such as the Pro Re Nata (PRN) or the Treat and Extend (T&E) schedule. To slow disease progression and to maintain visual acuity, in most cases repeated IVI have to be applied and frequent visits in ophthalmological centres are necessary. Intravitreal injections (IVI) with anti-vascular endothelial growth factor (VEGF) agents have revolutionized the treatment of exudative macular diseases, especially neovascular age-related macular degeneration (nAMD) and foveal macular oedema due to diabetic retinopathy or retinal vein occlusion. These aspects should be taken into account by healthcare professionals. Fear of the IVI and particularly of unfavourable examination results demonstrate the high treatment burden for patients undergoing anti-VEGF therapy. Most patients are satisfied with the IVI therapy and the treatment regimen. 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). The examination results are associated with fear in the majority of patients (53.3%). 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 majority considered PRN and T&E to be equal (60.3%). Comparing treatment regimen, 13.7% thought PRN was better and 23.3% felt T&E was better. Nearly all patients (90.5%) felt well informed about disease and therapy. P values ≤ 0.05 were considered statistically significant. Analysis of associations between answers of the questionnaire was executed using Pearson’s Chi 2 test and Mann–Whitney U test. 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. 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.
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