TY - JOUR
T1 - Qu estionnaire to A ssess L ife i mpact of T reatment by i ntravitreal i njections (QUALITII)
T2 - Development of a patient-reported measure to assess treatment burden of repeat intravitreal injections
AU - McClard, Cynthia K.
AU - Wang, Rui
AU - Windham, Victoria
AU - Munoz, Jose
AU - Gomez, Samuel
AU - Fried, Sagit
AU - Saroj, Namrata
AU - Regillo, Carl
AU - Wykoff, Charles Clifton
AU - Strutt, Adriana M.
N1 - Publisher Copyright:
© 2021 BMJ Publishing Group. All rights reserved.
PY - 2021/4/7
Y1 - 2021/4/7
N2 - Objective To understand patient burden of treatment of repeated intravitreal injections (IVI) in the management of exudative retinal diseases. Methods and analysis Participants were sampled from a large urban retina specialty practice in Houston, Texas, USA, based on history of ongoing receipt of IVI. The 50-item Questionnaire to Assess Life Impact of Treatment by Intravitreal Injections questionnaire was developed to evaluate the patient experience including discomfort, anxiety, inconvenience and satisfaction. Categorial principal components analysis (CATPCA) was performed to assess construct validity and internal consistency. A subset of these items was used to establish a measure of total treatment burden, referred to as the IVI Treatment Burden Score (TBS). Results 142 patients participated in this study. CATPCA analysis revealed five dimensions of patient burden: disruption of normal routine or capacity, anxiety, frequency of visits, chronicity of disease and perceived treatment value or satisfaction. Together, these dimensions accounted for 67% of variance explained. Cronbach's alpha was 0.97. The most frequently cited cause of discomfort was the feeling after anaesthetic wore off. The most common source of anxiety was fear of injection and associated discomfort or pain. Regarding inconvenience, patients reported temporary postinjection debilitation, requiring an average of 8 hours for recovery per treatment. The most frequently identified sources of satisfaction were confidence in the provider or treatment and interactions with staff. Conclusions Understanding and quantifying the patient burden associated with repeated IVI for exudative retinal diseases can reveal opportunities to improve delivery methods. The TBS could serve to inform strategies to maximise treatment adherence and optimise patient experiences.
AB - Objective To understand patient burden of treatment of repeated intravitreal injections (IVI) in the management of exudative retinal diseases. Methods and analysis Participants were sampled from a large urban retina specialty practice in Houston, Texas, USA, based on history of ongoing receipt of IVI. The 50-item Questionnaire to Assess Life Impact of Treatment by Intravitreal Injections questionnaire was developed to evaluate the patient experience including discomfort, anxiety, inconvenience and satisfaction. Categorial principal components analysis (CATPCA) was performed to assess construct validity and internal consistency. A subset of these items was used to establish a measure of total treatment burden, referred to as the IVI Treatment Burden Score (TBS). Results 142 patients participated in this study. CATPCA analysis revealed five dimensions of patient burden: disruption of normal routine or capacity, anxiety, frequency of visits, chronicity of disease and perceived treatment value or satisfaction. Together, these dimensions accounted for 67% of variance explained. Cronbach's alpha was 0.97. The most frequently cited cause of discomfort was the feeling after anaesthetic wore off. The most common source of anxiety was fear of injection and associated discomfort or pain. Regarding inconvenience, patients reported temporary postinjection debilitation, requiring an average of 8 hours for recovery per treatment. The most frequently identified sources of satisfaction were confidence in the provider or treatment and interactions with staff. Conclusions Understanding and quantifying the patient burden associated with repeated IVI for exudative retinal diseases can reveal opportunities to improve delivery methods. The TBS could serve to inform strategies to maximise treatment adherence and optimise patient experiences.
KW - neovascularisation
KW - retina
KW - treatment medical
UR - http://www.scopus.com/inward/record.url?scp=85103880078&partnerID=8YFLogxK
U2 - 10.1136/bmjophth-2020-000669
DO - 10.1136/bmjophth-2020-000669
M3 - Article
AN - SCOPUS:85103880078
SN - 2397-3269
VL - 6
JO - BMJ Open Ophthalmology
JF - BMJ Open Ophthalmology
IS - 1
M1 - e000669
ER -