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Preferences on neovascular age-related degeneration (nAMD) treatment shows clinicians and patients’ views on options

A research study assessing patient and retina specialists’ preferences on the treatment of nAMD has shown a valuable comparison on specific measures.  The “relative importance” (RI) of specific attributes showed that patients (P) and retina specialists (RS) have greater RI to improvements in visual function (Patients: 60.0%; Retina specialists: 52.7%), lower monitoring frequency (Patients: 20.2%; Retina specialists: 27.1%), and reduction in retinal fluid (Patients: 9.8%; Retina specialists: 13.0%), compared to cost and treatment regimens. According to the study, patients and retina specialists would agree on an increase in the treatment cost by 65.0% and 56.5%, respectively, in exchange for improvement in visual function, and by 25.5% and 43.3% for delaying the frequency of monitoring by one month.


In the study with nAMD patients, the cohort recruited a total of 110 patients (P) and 66 retina specialists (RS).  The  patient group recorded a mean age 79.0 years (SD 7.4); 57.3% women, [mean years from diagnosis 2.3 years (SD 0.7)] receiving intravitreal anti-VEGF therapy [mean years 2.1 (SD 0.1); 45.5% pro re nata (PRN), 44.5% treat-and-extend (T&E), 4.5% fixed and 6.4% other regimen]. As healthcare systems aim to support “shared decision making” according to the current study, there is a move to patient-centred care whereby “both physicians and patients share information, discuss treatment preferences and agree on their treatment plan”.  The current study showed significant differences were observed in the RI attached to visual function (VF), treatment plan and monitoring frequency.  It appears that the most important attribute for patients (60.0% VF) gave greater importance VF than to specialists (52.7% VF) (p<0.001). The lower monitoring frequency was 20.2% for patients, while the attribute on monitoring frequency for the specialists were 27.1%.  While this study was based in a single country (Spain), it may be interesting to see how similar metrics may compare to other jurisdictions / EU members states and / or global statistics.


Following the analysis, the study paper (PLoS ONE 16(12): e0261955) concluded that “efficacy of treatment, in terms of visual function improvements, is the main driver for treatment election for both patients and retina specialists. Treatment monitoring requirements are also considered, mainly from the retina specialist’s perspective. These results suggest that the use of more efficacious anti-VEGF agents with a longer duration of action may contribute to aligning treatment characteristics with patients/specialists’ preferences. A better alignment would facilitate better disease management, fulfilling the unmet needs of patients and retina specialists”.