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Missed Hospital Appointments of Patients Receiving Ranibizumab Therapy for Neovascular Age-Related Macular Degeneration.

Karampelas M, Pefkianaki M, Rees A, Gill N, Kotecha A, Hamilton R, Nikita E, Patel PJ - Ophthalmol Ther (2015)

Bottom Line: None of these MHAs occurred during the first 3 months after treatment initiation.Mean VA and central retinal thickness difference between 2 years and baseline for the MHA group was not statistically different compared with the non-MHA group.Our data suggest that MHA may be a relatively common occurrence in AMD treatment clinics, but good outcomes of treatment can be achieved over 2 years despite missed hospital visits if patients are reviewed on average six times in the first year after an initial loading phase of three injections and nine times in the second year of treatment.

View Article: PubMed Central - PubMed

Affiliation: NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, UK, mikekarampelas@hotmail.com.

ABSTRACT

Introduction: The aim of this study was to investigate the frequency and duration of missed hospital appointments (MHAs) in a consecutive cohort of patients treated with ranibizumab for neovascular age-related macular degeneration (nAMD) and to assess their impact on outcomes of therapy in a real-world clinical setting.

Methods: Retrospective, cross-sectional study of consecutive patients attending medical retina clinics for nAMD treatment with ranibizumab.

Results: Seventy-eight eyes of 78 patients met the inclusion criteria for data analysis. Mean age was 78 years with mean follow-up of 27 months. Mean visual acuity (VA) was 52 ± 16 letters at baseline, 56 ± 17 letters at year 1 and 58 ± 16 letters at year 2. At the end of the second year, 90% of the patients had lost <15 letters, 26% had gained ≥15 letters and 10% had lost ≥15 letters. Nineteen patients had at least one MHA (24%) over 2 years. There were 26 MHA episodes in total leading to a median duration of 79 days (range 35-159) between attended hospital visits. None of these MHAs occurred during the first 3 months after treatment initiation. Mean VA and central retinal thickness difference between 2 years and baseline for the MHA group was not statistically different compared with the non-MHA group.

Conclusions: Our data suggest that MHA may be a relatively common occurrence in AMD treatment clinics, but good outcomes of treatment can be achieved over 2 years despite missed hospital visits if patients are reviewed on average six times in the first year after an initial loading phase of three injections and nine times in the second year of treatment.

No MeSH data available.


Related in: MedlinePlus

Graph showing the mean visual acuity for the two groups at baseline, year 1 and year 2. MHAs missed hospital appointments, ETDRS Early Treatment Diabetic Retinopathy Study
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Related In: Results  -  Collection


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Fig1: Graph showing the mean visual acuity for the two groups at baseline, year 1 and year 2. MHAs missed hospital appointments, ETDRS Early Treatment Diabetic Retinopathy Study

Mentions: During the interval chosen for the study, 78 eyes of 78 patients met the inclusion criteria for data analysis. The mean age was 78 years (range 52–93 years) and the mean follow-up was 27 months (range 24–38 months). There were 43 women (55%) and all 78 patients were Caucasian. Mean VA was 52 ± 16 letters at baseline, 56 ± 17 letters at year 1 and 58 ± 16 letters at year 2. At the end of the second year, 90% of the patients had lost <15 letters, 26% had gained ≥15 letters and 10% had lost ≥15 letters. Mean CRT was 311 ± 87 μm at baseline, 273 ± 72 μm at year 1 and 250 ± 68 μm at year 2. Mean number of injections was 6.7 (range 3–12) in the first year and 4.9 (range 0–12) in the second year. Mean number of hospital visits was 9.4 (range 5–12) in the first year and 8.9 (range 3–12) in the second year. Nineteen patients had at least one MHA (24%). Two patients had three MHAs, 3 patients had two MHAs and 14 patients had one MHA. There were 26 MHA episodes in total with a median duration of 79 days (range 35–159). None of these MHAs occurred during the first 3 months after treatment initiation. Table 1 summarizes baseline demographics, baseline lesion size and subtypes for the two groups. Table 2 displays the treatment-related metrics and Table 3 summarizes the outcomes of ranibizumab therapy. There was no statistically significant difference between the two groups regarding baseline age, baseline VA, baseline CRT and baseline lesion size. In addition, the two groups were similar in terms of baseline lesion type (Table 1). Mean VA and CRT difference between 2 years and baseline for the MHA group was not statistically different compared with the non-MHA group (p = 0.981, p = 0.605, respectively) (Figs. 1 and 2).Table 1


Missed Hospital Appointments of Patients Receiving Ranibizumab Therapy for Neovascular Age-Related Macular Degeneration.

Karampelas M, Pefkianaki M, Rees A, Gill N, Kotecha A, Hamilton R, Nikita E, Patel PJ - Ophthalmol Ther (2015)

Graph showing the mean visual acuity for the two groups at baseline, year 1 and year 2. MHAs missed hospital appointments, ETDRS Early Treatment Diabetic Retinopathy Study
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4470979&req=5

Fig1: Graph showing the mean visual acuity for the two groups at baseline, year 1 and year 2. MHAs missed hospital appointments, ETDRS Early Treatment Diabetic Retinopathy Study
Mentions: During the interval chosen for the study, 78 eyes of 78 patients met the inclusion criteria for data analysis. The mean age was 78 years (range 52–93 years) and the mean follow-up was 27 months (range 24–38 months). There were 43 women (55%) and all 78 patients were Caucasian. Mean VA was 52 ± 16 letters at baseline, 56 ± 17 letters at year 1 and 58 ± 16 letters at year 2. At the end of the second year, 90% of the patients had lost <15 letters, 26% had gained ≥15 letters and 10% had lost ≥15 letters. Mean CRT was 311 ± 87 μm at baseline, 273 ± 72 μm at year 1 and 250 ± 68 μm at year 2. Mean number of injections was 6.7 (range 3–12) in the first year and 4.9 (range 0–12) in the second year. Mean number of hospital visits was 9.4 (range 5–12) in the first year and 8.9 (range 3–12) in the second year. Nineteen patients had at least one MHA (24%). Two patients had three MHAs, 3 patients had two MHAs and 14 patients had one MHA. There were 26 MHA episodes in total with a median duration of 79 days (range 35–159). None of these MHAs occurred during the first 3 months after treatment initiation. Table 1 summarizes baseline demographics, baseline lesion size and subtypes for the two groups. Table 2 displays the treatment-related metrics and Table 3 summarizes the outcomes of ranibizumab therapy. There was no statistically significant difference between the two groups regarding baseline age, baseline VA, baseline CRT and baseline lesion size. In addition, the two groups were similar in terms of baseline lesion type (Table 1). Mean VA and CRT difference between 2 years and baseline for the MHA group was not statistically different compared with the non-MHA group (p = 0.981, p = 0.605, respectively) (Figs. 1 and 2).Table 1

Bottom Line: None of these MHAs occurred during the first 3 months after treatment initiation.Mean VA and central retinal thickness difference between 2 years and baseline for the MHA group was not statistically different compared with the non-MHA group.Our data suggest that MHA may be a relatively common occurrence in AMD treatment clinics, but good outcomes of treatment can be achieved over 2 years despite missed hospital visits if patients are reviewed on average six times in the first year after an initial loading phase of three injections and nine times in the second year of treatment.

View Article: PubMed Central - PubMed

Affiliation: NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, UK, mikekarampelas@hotmail.com.

ABSTRACT

Introduction: The aim of this study was to investigate the frequency and duration of missed hospital appointments (MHAs) in a consecutive cohort of patients treated with ranibizumab for neovascular age-related macular degeneration (nAMD) and to assess their impact on outcomes of therapy in a real-world clinical setting.

Methods: Retrospective, cross-sectional study of consecutive patients attending medical retina clinics for nAMD treatment with ranibizumab.

Results: Seventy-eight eyes of 78 patients met the inclusion criteria for data analysis. Mean age was 78 years with mean follow-up of 27 months. Mean visual acuity (VA) was 52 ± 16 letters at baseline, 56 ± 17 letters at year 1 and 58 ± 16 letters at year 2. At the end of the second year, 90% of the patients had lost <15 letters, 26% had gained ≥15 letters and 10% had lost ≥15 letters. Nineteen patients had at least one MHA (24%) over 2 years. There were 26 MHA episodes in total leading to a median duration of 79 days (range 35-159) between attended hospital visits. None of these MHAs occurred during the first 3 months after treatment initiation. Mean VA and central retinal thickness difference between 2 years and baseline for the MHA group was not statistically different compared with the non-MHA group.

Conclusions: Our data suggest that MHA may be a relatively common occurrence in AMD treatment clinics, but good outcomes of treatment can be achieved over 2 years despite missed hospital visits if patients are reviewed on average six times in the first year after an initial loading phase of three injections and nine times in the second year of treatment.

No MeSH data available.


Related in: MedlinePlus