AGE-RELATED MACULAR DEGENERATION INJECTION FREQUENCY: Effects of Distance Traveled and Travel Support.

Autor:	Meer EA; Department of Ophthalmology., Targ S; School of Medicine, University of California, San Francisco, California., Zhang N; School of Medicine, University of California, San Francisco, California.; San Francisco VA Health Care System, San Francisco, California.; Department of Epidemiology and Biostatistics, University of California School of Medicina, San Francisco, California; and., Hoggatt KJ; School of Medicine, University of California, San Francisco, California.; San Francisco VA Health Care System, San Francisco, California., Mehta KM; School of Medicine, University of California, San Francisco, California.; Department of Epidemiology and Biostatistics, University of California School of Medicina, San Francisco, California; and., Brodie F; Department of Ophthalmology.; Department of Ophthalmology, San Francisco Veterans Affairs Medical Center, San Francisco, California.
Jazyk:	angličtina
Zdroj:	Retina (Philadelphia, Pa.) [Retina] 2024 Feb 01; Vol. 44 (2), pp. 230-236.
DOI:	10.1097/IAE.0000000000003947
Abstrakt:	Purpose: Although efficacious, intravitreal anti-vascular endothelial growth factor therapy regimens for neovascular age-related macular degeneration can prove difficult for patients to adhere to because of high cost and burden of transportation. Methods: Analysis of electronic health record data from the San Francisco Veterans Administration Medical Center eye clinic (January 1, 2010 to December 31, 2019) was performed, extracting demographic data, anti-vascular endothelial growth factor injection history, and enrollment in the SFVA travel benefit program. Two-tailed P -values were calculated for Poisson regression examining average number of injections per year as the outcome and distance traveled as the primary predictor. Travel benefit was evaluated as a modifying effect on the distance-injection relationship. Results: Three hundred and eighteen patients who received intravitreal injection for treatment of neovascular age-related macular degeneration were included in the analysis. Median (interquartile range) distance to clinic was 31.5 miles (7.4-69.4 miles). Driving distance in miles was inversely associated with average number of injections per year. Among all 318 patients, for every additional 100 miles a patient lived from our clinic, the patient received on average 2.5 fewer injections per year ( distance = -0.0025, P < 0.001), but this was not the case for patients with travel benefits ( distance = -0.0011, P = 0.362). Conclusion: The greater the distance from a patient's eye clinic, the lower the average number of injections per year. However, travel benefits mitigated this relationship, highlighting opportunities for improving patient's adherence through assistance programs.
Databáze:	MEDLINE
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