New data presented at the 6th World Congress on Controversies in Ophthalmology shows that the intravitreal injection regimens associated with treating retinal disease can have a detrimental effect on a patient’s quality of life.
In a presentation by Dr Sobha Sivaprasad, Consultant Ophthalmologist at Moorfields Eye Hospital, London, at the conference, it was said that 64% who undergo monthly eye injections say the main improvement they would like from their treatment regimen would be to reduce the frequency of injections (42%) or appointments (22%) whilst still achieving the same results.
The market research conducted amongst 131 patients with either retinal vein occlusion (RVO) or diabetic macular edema (DME) in Germany, Italy and the UK, reveals that as well as inducing anxiety, worry, and disturbed sleep patterns, each injection appointment has major practical implications due to the amount of time patients, and their carers, are required to take off work.
On average, patients spend a total of four and half hours traveling to their appointment and receiving their injection, with 53% of patients who work having to take at least one day off work. Of those, 25% take off two to three days to cover the injection day and recovery time, and 12% take up to five days. Unsurprisingly, this impact is not restricted to the patient, it also involves their carers and family. 71% of patients need the assistance of a caregiver to attend an appointment, resulting in 59% of caregivers who work being obliged to take time off.
Dr. Sivaprasad said at the meeting that the burden associated with loss of vision is well recognized, and it is important that retinal specialists seek to prevent visual deterioration with the treatments available. She added that clinicians have only recently really started to think about the true impact their choice of treatment can have on patients and their family.
For the average patient, an appointment is not limited to the 10 minutes they spend in the treatment room. It can actually mean more than 48 hours worrying and feeling anxious about the injection, over half a day traveling and attending the appointment, and for some, the added burden of having to ask a caregiver to sacrifice considerable amounts of their own time as well.
Clinicians need to consider all available treatment types, including newer options that require fewer appointments, especially when taken into account with the broader treatment commitments many patients have.
For those patients with DME, having diabetes means they are more likely to experience a range of co-morbid chronic diseases, requiring multiple appointments with a diverse range of healthcare specialists. The data presented at conference indicated that, over a six month period, the average DME patient could have approximately 19 appointments with their ophthalmologist, internist, diabetologist and/or retina specialist. On top of these, DME patients may also have additional appointments with neurologists, cardiologists and other specialists. The resulting impact on patient time is therefore significant and has the potential to make appointment attendance a challenge.
Dr. Sivaprasad added that clinicians must look at each patient holistically and understand that for many of them, managing their retinal condition adds an additional layer of complexity to their lives. Anything we can do to reduce the number of injections and visits to clinic is undoubtedly going to have a positive impact on quality of life for patients and their carers.
Reference: Sivaprasad S and Oyetunde S. Impact of injection therapy for retinal patients with DME or RVO, presented at 6th World Congress on Controversies in Ophthalmology, 26-29 March 2015.
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Photo credit: http://www.medicalobserver.com.au
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