Helping patients stick to eye injections
Specsavers and Macular Disease Foundation Australia have begun a strategic scoping partnership designed to enhance support for patients diagnosed with neovascular age-related macular degeneration (nAMD).
It’s estimated 156,0901 Australians have nAMD and require anti-VEGF intravitreal injection (IVI) treatment. Without treatment, patients with nAMD will progressively develop severe vision loss and blindness.2
Despite that, a mere 56,000 are estimated to receive nAMD IVI treatment3, and it is estimated that there is a 20-25% rate of non-adherence to treatment.4
Treatment burden, lack of perceived benefit, cost burden, the existence of other medical conditions that are more severe and clinical grounds (disease inactivity or futility) are among the major barriers to treatment.5
That’s why Specsavers and MDFA are working together on an Australia-first move to overcome preventable vision loss from nAMD by improving appointment attendance and treatment adherence rates for patients.
What the partnership involves
The program is designed to support nAMD suspects to attend their first ophthalmology appointment, then help them to adhere to the treatment their ophthalmologist prescribes.
The pilot program has begun in 16 Specsavers practices around Australia. Consenting patients with suspected nAMD are referred to MDFA via Oculo at the same time as their ophthalmologist referral.
MDFA then contacts the patient to answer any questions, urges them to attend their ophthalmologist appointment, and encourages them to join a treatment support program called ‘My Eyes’.6
MDFA also checks in after that appointment and keeps in touch according to their treatment intervals.
Plus, patients receive an e-newsletter tailored to their situation every two months, as well as the chance to join peer support groups for people living with nAMD.
What patients are saying
The partnership aims to overcome barriers to ensure every consenting patient is supported to adhere to prescribed treatment, including attending subsequent treatment appointments.
While the partnership is still in the pilot phase, 75% of eligible patients have elected to join ‘My Eyes’, and these first patients are adhering to their IVI treatment.
Patient Michael from Geelong in Victoria appreciates the regular reminders to attend appointments with his ophthalmologist.
“I will do everything to subvert any vision loss – the reminders are helpful as we can forget,” Michael said.
“The information given was very beneficial. Following on from that on a month-month to basis, the reminders were beneficial as it helps sift through inaccurate information. I definitely intend on keeping up treatment.
“The emails underscore how important the appointments are.”
Patient Elizabeth from Hervey Bay in Queensland cannot drive to the hospital, so she depends on Government transport. She also appreciates the regular reminders.
“The messages are important to know that it’s important to have the treatment and that the injections are working,” Elizabeth said.
“So long as I’m on treatment, I’m very happy.”
Patient Irene says that joining an MDFA peer support group has made her feel less alone, and helped her take her nAMD diagnosis seriously.
“I am just so grateful to my optometrist for getting me involved in this, as I don’t know anyone with nAMD and now I have the opportunity to interact with people who deal with the same problems as I have,” Irene said.
“I am full of hope, as I know this will improve my mental state and give me information, which would be most welcome.”
References
1. Deloitte Access Economics and Macular Degeneration Foundation (2011). Eyes on the future – A clear outlook on age-related macular degeneration. Accessed at https://mdfa-s3fs-prod.s3-ap-southeast-2.amazonaws.com/s3fs-public/Deloitte_Eyes_on_the_Future_Report_web.pdf. (2022 prevalence estimates are derived from a straight-line extrapolation between 2020 and 2025 estimates in this report.)
2. Wong T et al. (2007). The natural history and prognosis of neovascular age-related macular degeneration: a systematic review of the literature and meta-analysis. Ophthalmology. 2008 Jan;115(1):116-26. doi: 10.1016/j.ophtha.2007.03.008. Accessed at https://pubmed.ncbi.nlm.nih.gov/17675159/.
3. 6 Extrapolated to 2022 from: Ranibizumab and aflibercept: analysis of use for AMD, DMO, BRVO and CRVO. (2018) Accessed at https://www.pbs.gov.au/pbs/industry/listing/participants/public-release-docs/2018-05/ranibizumab_and_aflibercept__analysis_of_use_for_amd%2C_dmo%2C_b
4. Obeid A et al (2018). Loss to follow-up among patients with neovascular age-related macular degeneration who received intravitreal anti-vascular endothelial growth factor injections. JAMA Ophthalmol. 2018;136(11):1251-1259.
5. Vaze et al (2014). Reasons for discontinuation of intravitreal vascular endothelial growth factor inhibitors in neovascular age-related macular degeneration.
6. 8 MDFA’s My Eyes and other treatment adherence strategies are also supported by Roche, Apellis and Novartis.
Posted: 7 July 2022
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