Disengagement and loss to follow-up in intravitreal injection clinics for neovascular age-related macular degeneration
Disengagement and loss to follow-up in intravitreal injection clinics for neovascular age-related macular degeneration
Background/objectives: timely assessment and treatment of patients with neovascular AMD (nAMD) are crucial to preservation of vision. Loss to follow up (LTFU) in these patients is a problem but this has not been systematically investigated.
Subjects/methods: a retrospective review of electronic medical records of patients with nAMD first treated with anti-VEGF therapy from 1st Jan 2014 to 31st Dec 2018, was conducted in January 2021. Any patient not seen for more than 12 months was classed as no longer attending.
Results: of the 1328 patients who attended between 2014 and 2018, 348 had failed to attend and were eligible for inclusion in this study. Reasons noted for discontinuation of care: discharged by clinician (33.3%), died (20.7%), moved to another unit outside of area (17.5%), stopped attending due to ill-health (13.5%), discharged due to failure to attend (5.6%) and patient choice to no longer attend (4.6%). There were 16 (4.6%) who did not receive any further appointments despite clinician request for follow-up. After 5 years, 50.5% of patients were no longer attending for treatment. Age was a factor in failure to attend, with 7 out of 12 patients aged >100 years no longer being followed up, compared to 1 out of 11 of 50–59 year-olds.
Conclusions: when analysing visual outcomes in an AMD service it is important to characterise the patients who are lost to follow up. The outcomes for this group may be avoidably poor and understanding the factors influencing LTFU rate is crucial to addressing shortcomings in a hospital AMD service.
3186-3190
Jones, Rebecca
22c710c3-71e8-4ee4-9e6d-d67a6ea8b761
Stratton, Irene M.
772f25b9-23c0-4240-a3f6-1e76b03b172f
Scanlon, Peter H.
4e3d2310-c79e-42db-ae29-7a7d6b278aa3
Theodoropoulou, Sofia
b6e133cc-9925-411b-8628-32fec39a098e
October 2023
Jones, Rebecca
22c710c3-71e8-4ee4-9e6d-d67a6ea8b761
Stratton, Irene M.
772f25b9-23c0-4240-a3f6-1e76b03b172f
Scanlon, Peter H.
4e3d2310-c79e-42db-ae29-7a7d6b278aa3
Theodoropoulou, Sofia
b6e133cc-9925-411b-8628-32fec39a098e
Jones, Rebecca, Stratton, Irene M., Scanlon, Peter H. and Theodoropoulou, Sofia
(2023)
Disengagement and loss to follow-up in intravitreal injection clinics for neovascular age-related macular degeneration.
Eye (Basingstoke), 37 (15), .
(doi:10.1038/s41433-023-02474-3).
Abstract
Background/objectives: timely assessment and treatment of patients with neovascular AMD (nAMD) are crucial to preservation of vision. Loss to follow up (LTFU) in these patients is a problem but this has not been systematically investigated.
Subjects/methods: a retrospective review of electronic medical records of patients with nAMD first treated with anti-VEGF therapy from 1st Jan 2014 to 31st Dec 2018, was conducted in January 2021. Any patient not seen for more than 12 months was classed as no longer attending.
Results: of the 1328 patients who attended between 2014 and 2018, 348 had failed to attend and were eligible for inclusion in this study. Reasons noted for discontinuation of care: discharged by clinician (33.3%), died (20.7%), moved to another unit outside of area (17.5%), stopped attending due to ill-health (13.5%), discharged due to failure to attend (5.6%) and patient choice to no longer attend (4.6%). There were 16 (4.6%) who did not receive any further appointments despite clinician request for follow-up. After 5 years, 50.5% of patients were no longer attending for treatment. Age was a factor in failure to attend, with 7 out of 12 patients aged >100 years no longer being followed up, compared to 1 out of 11 of 50–59 year-olds.
Conclusions: when analysing visual outcomes in an AMD service it is important to characterise the patients who are lost to follow up. The outcomes for this group may be avoidably poor and understanding the factors influencing LTFU rate is crucial to addressing shortcomings in a hospital AMD service.
Text
s41433-023-02474-3
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More information
Accepted/In Press date: 27 February 2023
e-pub ahead of print date: 14 March 2023
Published date: October 2023
Additional Information:
Funding Information:
We are grateful to Ann Friend and Natasha Hill, AMD coordinators, without whom this research would not be possible, and to Miss Emily Fletcher and Mr Quresh Mohamed, who lead the AMD service.
Publisher Copyright:
© 2023, The Author(s).
Identifiers
Local EPrints ID: 487011
URI: http://eprints.soton.ac.uk/id/eprint/487011
ISSN: 0950-222X
PURE UUID: 415428af-e686-4fa2-805f-7021370962de
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Date deposited: 09 Feb 2024 17:40
Last modified: 18 Mar 2024 04:01
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Contributors
Author:
Rebecca Jones
Author:
Irene M. Stratton
Author:
Peter H. Scanlon
Author:
Sofia Theodoropoulou
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