A telephone call to remind patients undergoing antiangiogenic agent injection of a recheck can increase the correct sequence of appointments.
Introduction
Age-related macular degeneration is the leading cause of low vision in the western world for people over 50 years of age. One or both eyes can be affected by age-related macular degeneration. Central vision is reduced, however, peripheral vision remains intact.
There are two forms of age-related macular degeneration: the dry form (also known as non-exudative or atrophic form) and the wet form (or exudative) of age-related macular degeneration.
The most modern and effective treatment of wet-type age-related macular degeneration is the treatment with intravitreal injections with anti-VEGF, which achieves stabilization and improvement of central vision. The treatment is initially administered once a month for three months and then individualised. Close (monthly) monitoring of the patient suffering from wet-type age-related macular degeneration is essential to ensure the best possible outcome.
Next we present a very interesting study, carried out by a team of doctors at Wills Eye Hospital, which shows us that a telephone call to remind patients undergoing intravitreal injection of anti-VEGF (Anti VEGF) of their recheck can reduce the rates of non-adherence to their scheduled appointments.
The Study
According to the researchers, a small but statistically significant reduction in the non-adherence rate is observed when the appointment reminder system is followed by a telephone call. Adherence to these treatment regimens has proven difficult for both patients and physicians.
The study was conducted in a total of 9,690 patients and 84,613 injections between January 2016 and September 2019. Patients with a history of wet age-related macular degeneration (wet AMD), productive diabetic retinopathy (BDR) and retinal vein occlusion were included. Upon completion of the treatment regimen, patients who did not attend a visit were given an individual call to proceed to reprogramming.
The researchers studied two groups that started the injections before and after the telephone reminder was completed.
The group of patients who started the injections before the completion of the telephone reminder had a non-adherence rate of 5.5% and 2645 injections, while patients who started the injections after the completion of the telephone reminder had a non-adherence rate of 5.1% and 1872 injections.
The mean age of the patients at the start of the study was 72.9 years. In patients younger than 75 years of age at baseline, the nonadherence rate decreased significantly from 7.6% to 5.7% after implementation of the telephone reminder. However, a less high rate of non-adherence occurred in patients over 75 years of age.
In conclusion based on what the researchers report, this monitoring system appeared to be more effective depending on the key characteristics of the patients in the study, namely age, gender and disease severity. Further reductions in non-adherence rates may require a more comprehensive intervention.
