A global survey of 4,558 patients with neovascular age-related macular degeneration from 78 clinics across 24 countries identified key factors influencing patients’ adherence to treatment. The data analysis explored modifiable and non-modifiable elements with the potential to drive improvements in patient care and optimize clinic capacity.

According to the abstract presented at Euretina 2024, “patients who had not missed an appointment for treating neovascular age-related macular degeneration (nAMD) were considered adherent. Patients were considered partially adherent if they had missed at least 1 appointment since starting treatment, if they missed 1 appointment over a 1-year period, or both. All other patients were considered non-adherent.

The survey found patients living in rural areas or lacking reliable transportation were more likely to miss appointments. Anxiety and fear related to intravitreal injections, as well as discomfort during the procedure, were common reasons for non-adherence reported by many patients, and patients receiving more injections (up to 60) were more likely to be non-adherent.

In contrast, Dr. Daniel K. Bennett of North Carolina Retina Associates commented, "patients are more likely to remain adherent when they show significant interest in anti-compliment treatment modalities at their initial visit.  In my experience, physician enthusiasm regarding the medications and their vision stabilizing effects also provides patients with a sense of confidence in continued treatments."

Additionally, the timing of treatment and patient education proved to be important. Delays of 2 weeks to 2 months from diagnosis to treatment significantly increased the likelihood of non-adherence. Patients who received unclear or limited information about their condition and treatment had a higher chance of non-adherence.

Self-paid treatment and bilateral nAMD also increased the risk of non-adherence. However, the survey also found that patients with caregiver assistance adhered more to treatment regimens.

The researchers recommended further analyses to understand factors affecting non-adherence in patients with diabetic macular edema. The survey results could be used to create a model of a non-adherent individual which could help improve adherence and clinical efficiency, they added. 

The presented abstract from Euretina 2024 and a full list of author disclosures can be found here.