Importance of Treatment Duration: Unmasking Barriers and Discovering the Reasons for Undertreatment of Anti-VEGF Agents in Neovascular Age-Related Macular Degeneration

Bianka Sobolewska,1 Muhammed Sabsabi,1 Focke Ziemssen2,3 1Center for Ophthalmology, Eberhard- Karls University, Tuebingen, Germany; 2University Eye Hospital, Center for Ophthalmology, University of Tübingen, Tuebingen, Germany; 3Department of Ophthalmology, University Hospital Leipzig, Leipzig, Germ...

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Autores principales:	Sobolewska B, Sabsabi M, Ziemssen F
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	non-adherence anti-vegf treatment barriers age-related macular degeneration abq-ivt Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/6a79620c85de424a9217c19be01b832c
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spelling	oai:doaj.org-article:6a79620c85de424a9217c19be01b832c2021-12-02T17:28:08ZImportance of Treatment Duration: Unmasking Barriers and Discovering the Reasons for Undertreatment of Anti-VEGF Agents in Neovascular Age-Related Macular Degeneration1177-5483https://doaj.org/article/6a79620c85de424a9217c19be01b832c2021-10-01T00:00:00Zhttps://www.dovepress.com/importance-of-treatment-duration-unmasking-barriers-and-discovering-th-peer-reviewed-fulltext-article-OPTHhttps://doaj.org/toc/1177-5483Bianka Sobolewska,1 Muhammed Sabsabi,1 Focke Ziemssen2,3 1Center for Ophthalmology, Eberhard- Karls University, Tuebingen, Germany; 2University Eye Hospital, Center for Ophthalmology, University of Tübingen, Tuebingen, Germany; 3Department of Ophthalmology, University Hospital Leipzig, Leipzig, GermanyCorrespondence: Bianka SobolewskaCenter of Ophthalmology, Eberhard-Karls University, Elfriede-Aulhorn-Straße 7, Tuebingen, 72076, GermanyTel +49 7071 29-88088Fax +49 7071 29-3730Email bianka.sob@gmx.dePurpose: Since non-adherence (NA) to intravitreal therapy with VEGF drugs is one of the most important modifiable factors compromising treatment outcome of nAMD, the purpose of this study was to investigate the contributing factors and barriers during long-term nAMD treatment.Methods: Barriers and potential reasons for NA were prospectively measured using the Adherence Barriers Questionnaire Intravitreal Therapy (ABQ-IVT). A random sample of patients receiving intravitreal therapy was drawn based on data for different treatment periods. Three age-sex matched groups included the treatment periods of ≤ 30 months (group 1), between > 30 months and ≤ 60 months (group 2), and > 60 months (group 3). The occurrence of gaps between treatments and/or OCT visits was evaluated.Results: NA with gaps of > 56 days after the scheduled appointment was detected in 39%, 89%, and 100% of patients in group 1, 2, and 3, respectively (groups 1 and 2 vs group 3, p < 0.001). Two or more of such gaps were observed in 6%, 72%, and 94% of patients in group 1, 2, and 3, respectively. The overall ABQ-IVT score showed corresponding differences between the groups: 25.89 ± 7.68 (group 1, 95% CI 22.07– 29.71), 34.72 ± 10.32 (group 2, 95% CI: 29.59– 38.86), and 33.28 ± 9.04 (group 3, 95% CI 28.78– 37.77). Accordingly, the score was inversely correlated with the number of regular follow-up visits in groups 2 and 3 (Pearson correlation coefficient r = − 0.65 (p = 0.003) and r = − 0.5 (p = 0.034), respectively). Within the groups of longer treatment duration, univariate logistic regression analysis showed higher odds of time commitment and challenge accompanying person to be relevant barriers.Conclusion: NA is an arising problem with increasing duration of intravitreal therapy. Treatment barriers, detected by the ABQ-IVT, might change or increase during the course of the treatment.Keywords: non-adherence, anti-VEGF, treatment barriers, age-related macular degeneration, ABQ-IVTSobolewska BSabsabi MZiemssen FDove Medical Pressarticlenon-adherenceanti-vegftreatment barriersage-related macular degenerationabq-ivtOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 15, Pp 4317-4326 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	non-adherence anti-vegf treatment barriers age-related macular degeneration abq-ivt Ophthalmology RE1-994
spellingShingle	non-adherence anti-vegf treatment barriers age-related macular degeneration abq-ivt Ophthalmology RE1-994 Sobolewska B Sabsabi M Ziemssen F Importance of Treatment Duration: Unmasking Barriers and Discovering the Reasons for Undertreatment of Anti-VEGF Agents in Neovascular Age-Related Macular Degeneration
description	Bianka Sobolewska,1 Muhammed Sabsabi,1 Focke Ziemssen2,3 1Center for Ophthalmology, Eberhard- Karls University, Tuebingen, Germany; 2University Eye Hospital, Center for Ophthalmology, University of Tübingen, Tuebingen, Germany; 3Department of Ophthalmology, University Hospital Leipzig, Leipzig, GermanyCorrespondence: Bianka SobolewskaCenter of Ophthalmology, Eberhard-Karls University, Elfriede-Aulhorn-Straße 7, Tuebingen, 72076, GermanyTel +49 7071 29-88088Fax +49 7071 29-3730Email bianka.sob@gmx.dePurpose: Since non-adherence (NA) to intravitreal therapy with VEGF drugs is one of the most important modifiable factors compromising treatment outcome of nAMD, the purpose of this study was to investigate the contributing factors and barriers during long-term nAMD treatment.Methods: Barriers and potential reasons for NA were prospectively measured using the Adherence Barriers Questionnaire Intravitreal Therapy (ABQ-IVT). A random sample of patients receiving intravitreal therapy was drawn based on data for different treatment periods. Three age-sex matched groups included the treatment periods of ≤ 30 months (group 1), between > 30 months and ≤ 60 months (group 2), and > 60 months (group 3). The occurrence of gaps between treatments and/or OCT visits was evaluated.Results: NA with gaps of > 56 days after the scheduled appointment was detected in 39%, 89%, and 100% of patients in group 1, 2, and 3, respectively (groups 1 and 2 vs group 3, p < 0.001). Two or more of such gaps were observed in 6%, 72%, and 94% of patients in group 1, 2, and 3, respectively. The overall ABQ-IVT score showed corresponding differences between the groups: 25.89 ± 7.68 (group 1, 95% CI 22.07– 29.71), 34.72 ± 10.32 (group 2, 95% CI: 29.59– 38.86), and 33.28 ± 9.04 (group 3, 95% CI 28.78– 37.77). Accordingly, the score was inversely correlated with the number of regular follow-up visits in groups 2 and 3 (Pearson correlation coefficient r = − 0.65 (p = 0.003) and r = − 0.5 (p = 0.034), respectively). Within the groups of longer treatment duration, univariate logistic regression analysis showed higher odds of time commitment and challenge accompanying person to be relevant barriers.Conclusion: NA is an arising problem with increasing duration of intravitreal therapy. Treatment barriers, detected by the ABQ-IVT, might change or increase during the course of the treatment.Keywords: non-adherence, anti-VEGF, treatment barriers, age-related macular degeneration, ABQ-IVT
format	article
author	Sobolewska B Sabsabi M Ziemssen F
author_facet	Sobolewska B Sabsabi M Ziemssen F
author_sort	Sobolewska B
title	Importance of Treatment Duration: Unmasking Barriers and Discovering the Reasons for Undertreatment of Anti-VEGF Agents in Neovascular Age-Related Macular Degeneration
title_short	Importance of Treatment Duration: Unmasking Barriers and Discovering the Reasons for Undertreatment of Anti-VEGF Agents in Neovascular Age-Related Macular Degeneration
title_full	Importance of Treatment Duration: Unmasking Barriers and Discovering the Reasons for Undertreatment of Anti-VEGF Agents in Neovascular Age-Related Macular Degeneration
title_fullStr	Importance of Treatment Duration: Unmasking Barriers and Discovering the Reasons for Undertreatment of Anti-VEGF Agents in Neovascular Age-Related Macular Degeneration
title_full_unstemmed	Importance of Treatment Duration: Unmasking Barriers and Discovering the Reasons for Undertreatment of Anti-VEGF Agents in Neovascular Age-Related Macular Degeneration
title_sort	importance of treatment duration: unmasking barriers and discovering the reasons for undertreatment of anti-vegf agents in neovascular age-related macular degeneration
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/6a79620c85de424a9217c19be01b832c
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Importance of Treatment Duration: Unmasking Barriers and Discovering the Reasons for Undertreatment of Anti-VEGF Agents in Neovascular Age-Related Macular Degeneration

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