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Socio-economic status and outcomes for patients with age-related macular degeneration

Socio-economic status and outcomes for patients with age-related macular degeneration
Socio-economic status and outcomes for patients with age-related macular degeneration
Objectives: to explore disparities in severity of baseline disease, treatment completion and treatment outcomes among patients with wet age-related macular degeneration (AMD) receiving anti-vascular endothelial growth factor therapy by socio-economic status (SES) and distance from home to hospital. 

Study design: retrospective cohort study.
Methods: data from clinic records of 756 wet AMD patients receiving treatment for wet AMD with aflibercept between May 2013 and Jan 2017 were obtained. Area SES (using Index of Multiple Deprivation (IMD) 2015) and distance from hospital (dichotimised >=10 vs <10km), were derived from anonymized postcodes. Univariate and multivariable logistic regression models were used to identify associations of area deprivation and distance from hospital at baseline, with visual acuity (VA) at baseline, treatment completion and treatment outcome.

Results: living in the most deprived compared with less deprived areas was associated with a significantly higher risk of presenting with severe reduction in VA (OR=3.59; 95% CI=1.39-9.27; P=.01). This association was maintained after adjustment for age, gender and distance from hospital.On univariate analysis, delayed treatment completion was more likely in those living in most deprived areas (OR=2.80; 95% CI=1.21-6.47; P=.04), though this association was attenuated after adjustment for age, gender and distance from hospital.No association was observed between SES and treatment outcomes or between distance from hospital and baseline VA, treatment completion or treatment outcome.

Conclusion: this study found poorer baseline VA among people with wet AMD from more deprived areas. This work suggests a need for earlier identification of AMD among more deprived populations.
0950-222X
More, Pradnya
7a6e7864-cfbf-4a3a-9914-9ef2cf98af8e
Almuhtaseb, Hussein
27fcdbb3-4784-483d-823c-c6dae6151578
Smith, Dianna
e859097c-f9f5-4fd0-8b07-59218648e726
Fraser, Simon
135884b6-8737-4e8a-a98c-5d803ac7a2dc
Lotery, Andrew
5ecc2d2d-d0b4-468f-ad2c-df7156f8e514
More, Pradnya
7a6e7864-cfbf-4a3a-9914-9ef2cf98af8e
Almuhtaseb, Hussein
27fcdbb3-4784-483d-823c-c6dae6151578
Smith, Dianna
e859097c-f9f5-4fd0-8b07-59218648e726
Fraser, Simon
135884b6-8737-4e8a-a98c-5d803ac7a2dc
Lotery, Andrew
5ecc2d2d-d0b4-468f-ad2c-df7156f8e514

More, Pradnya, Almuhtaseb, Hussein, Smith, Dianna, Fraser, Simon and Lotery, Andrew (2019) Socio-economic status and outcomes for patients with age-related macular degeneration. Eye. (doi:10.1038/s41433-019-0393-3).

Record type: Article

Abstract

Objectives: to explore disparities in severity of baseline disease, treatment completion and treatment outcomes among patients with wet age-related macular degeneration (AMD) receiving anti-vascular endothelial growth factor therapy by socio-economic status (SES) and distance from home to hospital. 

Study design: retrospective cohort study.
Methods: data from clinic records of 756 wet AMD patients receiving treatment for wet AMD with aflibercept between May 2013 and Jan 2017 were obtained. Area SES (using Index of Multiple Deprivation (IMD) 2015) and distance from hospital (dichotimised >=10 vs <10km), were derived from anonymized postcodes. Univariate and multivariable logistic regression models were used to identify associations of area deprivation and distance from hospital at baseline, with visual acuity (VA) at baseline, treatment completion and treatment outcome.

Results: living in the most deprived compared with less deprived areas was associated with a significantly higher risk of presenting with severe reduction in VA (OR=3.59; 95% CI=1.39-9.27; P=.01). This association was maintained after adjustment for age, gender and distance from hospital.On univariate analysis, delayed treatment completion was more likely in those living in most deprived areas (OR=2.80; 95% CI=1.21-6.47; P=.04), though this association was attenuated after adjustment for age, gender and distance from hospital.No association was observed between SES and treatment outcomes or between distance from hospital and baseline VA, treatment completion or treatment outcome.

Conclusion: this study found poorer baseline VA among people with wet AMD from more deprived areas. This work suggests a need for earlier identification of AMD among more deprived populations.

Other
More AMD Article Eye 2019 - Accepted Manuscript
Restricted to Repository staff only until 7 August 2019.
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More information

Accepted/In Press date: 7 February 2019
e-pub ahead of print date: 11 March 2019

Identifiers

Local EPrints ID: 429116
URI: https://eprints.soton.ac.uk/id/eprint/429116
ISSN: 0950-222X
PURE UUID: 671d144c-d8a2-43a8-97e1-8801f900bfa7
ORCID for Simon Fraser: ORCID iD orcid.org/0000-0002-4172-4406
ORCID for Andrew Lotery: ORCID iD orcid.org/0000-0001-5541-4305

Catalogue record

Date deposited: 21 Mar 2019 17:30
Last modified: 07 May 2019 00:34

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