Abstract
AbstractPurposeThe acceptability of emerging intravitreal therapies for patients with Geographic Atrophy (GA) is currently unknown. This study therefore aimed to: investigate whether regular intravitreal injections will be acceptable as treatment for GA patients; identify which attributes of current treatments in late stage development patients find less acceptable; and explore whether patient-related factors influence GA treatment acceptability.DesignExploratory, cross-sectional, mixed-methods study.Participants30 UK-based individuals with GA secondary to age-related macular degeneration (AMD), recruited from two London-based hospitals, interviewed in April-October 2021.MethodsParticipants responded to a structured questionnaire, as well as open-ended questions in a semi-structured interview. Quantitative data were analysed using descriptive statistics and non-parametric measures of correlation. Qualitative data were analysed using the framework method of analysis, informed by the Theoretical Framework of Acceptability.Main outcome measuresMain quantitative measures were Likert-type scale responses about acceptability of GA treatments. Qualitative outcomes of interest related to participants’ hopes, concerns and understanding of the proposed new intravitreal treatments for GA.ResultsTwenty participants (67%) were female, and median (interquartile range (IQR)) age was 83 (78, 87) years. 37% of participants had foveal centre-involving GA, and better eye median (IQR) logMAR visual acuity was 0.30 (0.17, 0.58). Data suggested that 18 participants (60% (95% CI: 41-79%)) would accept the treatment if offered today, despite their awareness of potential drawbacks. Eight participants (27% (95% CI: 10-43%) were ambivalent or undecided about treatment, and four (13%) (95% CI: 0-26%) would be unlikely to accept treatment. Reducing the frequency of injections from monthly to every other month increased the proportion of participants who considered the treatments acceptable.Qualitative data indicated that participants’ prioritisation of continuation with vision-specific activities influenced treatment acceptability. Conversely, factors limiting acceptability clustered around: the limited magnitude of treatment efficacy; concerns about side effects or the increased risk of neovascular AMD; and the logistical burden of regular clinic visits for intravitreal injections. Misunderstandings of potential benefits indicate the need for appropriately designed patient education tools to support decision-making.ConclusionsOur study suggests a majority of participants would be positive about intravitreal treatment for GA, in spite of potential burdens.
Publisher
Cold Spring Harbor Laboratory