In a recent study, patient preferences in the management of wet age-related macular degeneration (AMD) have reported several treatment attributes using patient-centred methods. Patients with wet AMD were keenly engaged on their own assessment of quality of life (QoL) measurements, such as mobility, use of a computer using activities, reading, driving, duration of therapy, route of administration, number of hospital visits and several more. The study data showed the degree of harmonization of preferences across multiple geographies and that participants actively adopt behaviours required for improved treatment outcomes. The preferences of selected drivers may inform future clinical development.
The study recruited 466 patients across 10 geographies from the USA, Canada, UK, France, Spain, Germany, Italy, Japan, Taiwan, and Australia (mean age, 68 years; women, 54%; binocular wet AMD, 28% and with an average anti-VEGF treatment duration of 3.9 years). According to the authors (Skelly et al., Adv Ther (2022) 39:4808–4820), the researchers commented that, “understanding patient preferences on disease and treatment attributes from a patient perspective may support shared treatment decision making that can optimize patient outcomes, treatment adherence, and treatment satisfaction”. The survey conducted six domains of assessment with 21 attributes, selected on the basis of a literature review, social media listening, and tele-interviews/discussions with patients, clinical experts, and patient groups. Scores were generated for each attribute and utility difference significance testing was performed using “unequal variances t tests”. The Patient Activation Measure (PAM-13) questionnaire was administered to assess patients’ knowledge, skill, and confidence in self-management.
Results from the analyses showed that the most important preference domains were “treatment effects on vision” (non-significant) and “vision-related symptom burdens” (p < 0.001), followed by “treatment risk” (p < 0.05), “impact on daily activities” (p < 0.05), “burden of clinic/hospital visits” (p < 0.001), and “impact on psychological well-being”. The five most important attributes in order of importance were “clarity of vision, treatment effect on symptoms, quality of vision, time to treatment effect, and time to re-administration”. The two most important attributes globally were also in the top three attributes across countries. Concluding on their research, the study authors commented that, “[m]anagement of wet AMD has a significant impact on patients and caregivers. Optimizing wet AMD treatment according to patient preference may bring an improvement in treatment outcomes and overall adherence to therapy. The results of this study have identified the most important/relevant treatment attributes to patients using patient-centred methods. The results of this study may further help inform future clinical trial development and discussions with health technology assessment (HTA) agencies on wet AMD”.