Treatment Burden and Quality of Life in Patients With nAMD and DME in Colombia: A Mixed Methods Study
Author(s)
Melissa Diaz, MSc, MD1, Mauricio Arango, MD2, Luis Carlos Escaf, MD3, Victor Flórez, MD4, Kelly Montes, MD5, Pérez Daniel, MD6, Juan Lugo Prada, MD7, Juan Camilo Sánchez-Thorin, MD8, Jorge Satizabal, MD9, Juan Carlos Silva, MD10, Diana Camila Buitrago, PhD, MSc11, Mauricio Hernandez, MD12, Laura Catalina Prieto, MD, MSc1.
1Evidence Generation, Roche Colombia, Bogotá, Colombia, 2Clínica Clofán, Medellín, Colombia, 3Clínica Oftalmológica del Caribe, Barranquilla, Colombia, 4Clínica Paredes, Pasto, Colombia, 5SO Servicios médicos y oftalmológicos, Bogotá, Colombia, 6Hospital Militar Central, Bogotá, Colombia, 7Centro médico especialistas en oriente, Medellín, Colombia, 8Fundacion Santa Fe de Bogotá, Bogota, Colombia, 9Clínica Sigma, Cali, Colombia, 10Consultor, Bogotá, Colombia, 11IQVIA, Manizales, Colombia, 12Medical Affairs, Roche Colombia, Bogotá, Colombia.
1Evidence Generation, Roche Colombia, Bogotá, Colombia, 2Clínica Clofán, Medellín, Colombia, 3Clínica Oftalmológica del Caribe, Barranquilla, Colombia, 4Clínica Paredes, Pasto, Colombia, 5SO Servicios médicos y oftalmológicos, Bogotá, Colombia, 6Hospital Militar Central, Bogotá, Colombia, 7Centro médico especialistas en oriente, Medellín, Colombia, 8Fundacion Santa Fe de Bogotá, Bogota, Colombia, 9Clínica Sigma, Cali, Colombia, 10Consultor, Bogotá, Colombia, 11IQVIA, Manizales, Colombia, 12Medical Affairs, Roche Colombia, Bogotá, Colombia.
OBJECTIVES: To describe the treatment burden and quality of life (QoL) of Colombian patients with neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME) treated with anti-VEGF therapies, and to identify adherence barriers, treatment satisfaction, patient and caregiver preferences.
METHODS: A mixed-method explanatory study evaluated through a quantitative survey quality of life in 62 nAMD and 46 DME adult patients using the NEI-VFQ-25 questionnaire. Treatment satisfaction was assessed using the MacTSQ for nAMD patients and RetTSQ for DME patients. Semi-structured interviews with 15 patients and 4 caregivers explored adherence barriers and treatment preferences. Findings were integrated using thematic analysis and data triangulation. Patients included had received anti-VEGF treatment within the last 6 months.
RESULTS: The study sample comprised 62% females. Bilateral eye involvement was reported in 54.6% of cases, with Aflibercept being the primary anti-VEGF agent (86.7%). The average NEI-VFQ-25 composite score was 59.2 with domains showing impairment in mental health, driving, and dependence in both diseases. Treatment satisfaction was lowest among patients with DME when they had bilateral vs unilateral disease (RetTSQ 70.6 vs 58.5) and with >6 injections, compared to 3-6 and <3 (59, 71.3, 73). Qualitative findings highlighted that patients faced significant financial burdens, long waiting times, and disruptions to daily routines due to their disease. Patients appreciated the treatment for improved vision despite challenges, preferring regimens that reduced visit frequency. The main reason for treatment adherence among patients with nAMD/DME is the desire to preserve their vision, supported by family or caregiver involvement and clear communication and trust in the doctor-patient relationship.
CONCLUSIONS: Anti-VEGF therapies improve perceived vision in nAMD and DME patients, but high treatment burden and logistical barriers hinder adherence and QoL. Addressing these factors through tailored strategies, enhanced doctor-patient communication, and caregiver inclusion is critical to optimize outcomes in real-world settings.
METHODS: A mixed-method explanatory study evaluated through a quantitative survey quality of life in 62 nAMD and 46 DME adult patients using the NEI-VFQ-25 questionnaire. Treatment satisfaction was assessed using the MacTSQ for nAMD patients and RetTSQ for DME patients. Semi-structured interviews with 15 patients and 4 caregivers explored adherence barriers and treatment preferences. Findings were integrated using thematic analysis and data triangulation. Patients included had received anti-VEGF treatment within the last 6 months.
RESULTS: The study sample comprised 62% females. Bilateral eye involvement was reported in 54.6% of cases, with Aflibercept being the primary anti-VEGF agent (86.7%). The average NEI-VFQ-25 composite score was 59.2 with domains showing impairment in mental health, driving, and dependence in both diseases. Treatment satisfaction was lowest among patients with DME when they had bilateral vs unilateral disease (RetTSQ 70.6 vs 58.5) and with >6 injections, compared to 3-6 and <3 (59, 71.3, 73). Qualitative findings highlighted that patients faced significant financial burdens, long waiting times, and disruptions to daily routines due to their disease. Patients appreciated the treatment for improved vision despite challenges, preferring regimens that reduced visit frequency. The main reason for treatment adherence among patients with nAMD/DME is the desire to preserve their vision, supported by family or caregiver involvement and clear communication and trust in the doctor-patient relationship.
CONCLUSIONS: Anti-VEGF therapies improve perceived vision in nAMD and DME patients, but high treatment burden and logistical barriers hinder adherence and QoL. Addressing these factors through tailored strategies, enhanced doctor-patient communication, and caregiver inclusion is critical to optimize outcomes in real-world settings.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
P19
Topic
Patient-Centered Research
Topic Subcategory
Adherence, Persistence, & Compliance, Patient-reported Outcomes & Quality of Life Outcomes
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity), Geriatrics, Sensory System Disorders (Ear, Eye, Dental, Skin)