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[年龄相关性黄斑变性治疗延迟和中断的原因]

[Reasons for delayed and discontinued therapy in age-related macular degeneration].

作者信息

Wintergerst M W M, Bouws J, Loss J, Heimes B, Pauleikhoff D, Holz F G, Finger R P

机构信息

Universitäts-Augenklinik Bonn, Bonn, Deutschland.

AMD-Netz, Münster, Deutschland.

出版信息

Ophthalmologe. 2018 Dec;115(12):1035-1041. doi: 10.1007/s00347-017-0610-z.

Abstract

BACKGROUND

Critical prerequisites for successful therapy of neovascular age-related macular degeneration (nvAMD) are an early initiation and continuous monitoring; however, delays in starting therapy and non-medically indicated discontinuation of therapy are frequent, which limits therapy efficacy and, thus, visual outcomes.

OBJECTIVE

To identify the reasons for delay in therapy and non-medically indicated termination of therapy.

MATERIAL AND METHODS

Patients who had started a new therapy (starters) and those who independently terminated therapy (dropouts) were interviewed by telephone with a specific, standardized questionnaire. Results were summarized descriptively.

RESULTS

A total of 100 starters and 55 dropouts were interviewed. The mean therapy delay was 22 (±28 SD) days. This was mainly due to the time until the decision to see an ophthalmologist was made. Main reasons for dropping out were: transportation issues (27%), poor general health (25%) and the assumption that there is no benefit from therapy (11%). Of the patients who dropped out 63% would have liked to continue therapy.

CONCLUSION

There is potential for improvement in nvAMD management regarding therapy start as well as therapy maintenance. Sensitizing for initial nvAMD symptoms is important as is reduction of barriers to therapy maintenance, since most therapy dropouts would like to continue the therapy.

摘要

背景

成功治疗新生血管性年龄相关性黄斑变性(nvAMD)的关键前提是早期开始治疗并持续监测;然而,开始治疗的延迟和非医学指征的治疗中断很常见,这限制了治疗效果,进而影响视力预后。

目的

确定治疗延迟和非医学指征的治疗终止的原因。

材料与方法

通过电话使用特定的标准化问卷对开始新治疗的患者(起始者)和自行终止治疗的患者(退出者)进行访谈。结果进行描述性总结。

结果

共访谈了100名起始者和55名退出者。平均治疗延迟为22(±28标准差)天。这主要是由于直到决定看眼科医生所花费的时间。退出的主要原因是:交通问题(27%)、总体健康状况差(25%)以及认为治疗无益处(11%)。在退出治疗的患者中,63%的人希望继续治疗。

结论

在nvAMD的管理方面,无论是治疗开始还是治疗维持都有改进的空间。提高对nvAMD初始症状的敏感度很重要,减少治疗维持的障碍也很重要,因为大多数治疗退出者希望继续治疗。

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