Treatment satisfaction of patients undergoing ranibizumab therapy for neovascular age-related macular degeneration in a real-life setting

Figures & data

Table 1 Macular Treatment Satisfaction Questionnaire (MacTSQ)

1	How satisfied are you with the treatment of your AMD?
2	How bothered are you with the side effects or after effects you experience with the treatment of AMD?
3	How bothered are you by any discomfort or pain of the treatment of your AMD?
4	How well do you feel your treatment of AMD is working?
5	How unpleasant did you find your treatment of AMD?
6	How apprehensive did you feel about your most recent treatment of AMD?
7	How satisfied are you about the costs to you associated with the treatment of your AMD?
8	How satisfied are you with the safety of the treatment of your AMD?
9a	Were you given information about your AMD treatment (eg, information about procedures, benefits, and any risks)?
9b	Was the information given to you in the way you can take home (eg, in a leaflet)?
9c	How satisfied are you with the information provided about the treatment of your AMD?
10	If further treatment is required for your AMD, how satisfied would you be to continue or repeat the treatment?
11	How satisfied are you with the time spent in the clinic on each treatment day?
12	How satisfied are you with the overall duration of the treatment for your AMD?
13	Would you encourage someone else with AMD like yours to have this kind of treatment?
14	Are there any other aspects of the treatment for your AMD, causing satisfaction or dissatisfaction, that have not been covered already?

Abbreviation: AMD, age-related macular degeneration.

Table 2 Client Service Questionnaire (CSQ-8)

Question	Responses
1. How would you rate the quality of service you received?	4 Excellent	3 Good	2 Fair	1 Poor
2. Did you get the kind of service you wanted?	1 No, definitely not	2 No, not really	3 Yes, generally	4 Yes, definitely
3. To what extent has our program met your needs?	4 Almost all of my needs have been met	3 Most of my needs have been met	2 Only a few of my needs have been met	1 None of my needs have been met
4. If a friend were in need of similar help, would you recommend our program to him or her?	1 No, definitely not	2 No, not really	3 Yes, generally	4 Yes, definitely
5. How satisfied are you with the amount of help you have received?	1 Quite dissatisfied	2 Indifferent or mildly dissatisfied	3 Mostly satisfied	4 Very satisfied
6. Have the services you received helped you to deal more effectively with your problems?	4 Yes, they helped a great deal	3 Yes, they helped somewhat	2 No, they really did not help	1 No, they seemed to make things worse
7. In an overall, general sense, how satisfied are you with the service you have received?	4 Very satisfied	3 Mostly satisfied	2 Indifferent or mildly dissatisfied	1 Quite dissatisfied
8. If you were to seek help again, would you come back to our program? Any comments or suggestions?	1 No, definitely not	2 No, I don’t think so	3 Yes, I think so	4 Yes, definitely

Note: Questions 2, 4, 5, and 8 are reverse scored.

Table 3 Patient characteristics

Variable	n (%)
Demographic
Age in years, mean age ± SD	79.6±8.8
≥80 years	138 (55.2)
70–80	81 (32.4)
60–69	24 (9.6)
50–59	7 (2.8)
Sex
Male	64 (25.6)
Female	186 (74.4)
Living alone
Yes	90 (36)
No	160 (64)
Marital status
Single	11 (4.4)
Married/partner	134 (53.6)
Separated/divorced	19 (7.6)
Widowed	86 (34.4)
Employment status
Employed	14 (5.6)
Unemployed	1 (0.4)
Retired	235 (94.0)
Visual acuity
Visual acuity in better eye (ETDRS letters)
≥74	122 (48.8)
54–73	93 (37.2)
<54	35 (14.0)
Visual acuity in worse eye (ETDRS letters)
≥74	27 (10.8)
54–73	69 (27.6)
37–53	31 (12.4)
<37	123 (49.2)
NEI-VFQ-25 total composite and score profile
Mean total, mean ± SD	56.1±22.0
≥90	11 (4.8)
80–89	30 (13.1)
70–79	33 (14.4)
60–69	22 (9.6)
50–59	29 (12.7)
40–49	30 (13.1)
30–39	32 (14.0)
<30	42 (18.3)
Mean duration AMD (months), mean ± SD	36.2±20.7
Care, treatment, and therapy outcome
Number of appointments
≤3	20 (8.1)
4–6	23 (9.3)
7–9	33 (13.4)
≥10	132 (53.4)
Number of ranibizumab injections
≤3	37 (15.0)
4–6	45 (18.2)
7–9	33 (13.4)
≥10	132 (53.4)
VA change post-treatment, mean ± SD
Overall	4.9±21
Health-related quality of life, mean ± SD
EQ-5D-3L
Index	0.68±0.22
VAS	64.6±15.0
MacDQoL
Total	−0.6591.8

Note: Data shown as mean ± SD and n (%).

Abbreviations: AMD, age-related macular degeneration; MacDQol, macular disease-specific-related quality of life; SD, standard deviation; VA, visual acuity; VAS, visual analog score; NEI-VFQ-25, 25-item National Eye Institute Visual Function Questionnaire; ETDRS, early treatment diabetic retinopathy study.

Table 4 Correlation matrix of continuous variables

	1	2	3	4	5	6	7	8	9	10	11
	MacTSQ (total)	CSQ-8	Age	Duration AMD	VA change	Number of injections	Number of appointments	VFQ (total)	MacDQoL	EQ-5D-3L VAS	EQ-5D-3L Index
1		−0.27**	0.08	0.17**	0.09	0.14*	0.21**	0.12	0.03	0.10	0.25**
2	−0.27**		−0.04	−0.07	−0.20**	−0.06	−0.09	−0.16*	0.07	−0.24**	−0.19**
3	0.08	−0.04		0.25**	−0.24**	0.09	0.20**	−0.01	0.03	−0.04	−0.02
4	0.17**	−0.07	0.25**		0.01	0.69**	0.61**	−0.02	0.16**	−0.07	0.07
5	0.09	−0.20**	−0.24**	0.01		0.08	0.04	0.00	−0.19**	0.22**	0.02
6	0.14*	−0.06	0.09	0.69**	0.08		0.59**	−0.03	0.10	−0.05	0.04
7	0.21**	−0.09	0.20**	0.61**	0.04	0.59**		−0.10	0.13*	0.08	0.09
8	0.12	−0.16*	−0.01	−0.02	0.00	−0.03	−0.10		−0.27**	0.12	0.36**
9	0.03	0.07	0.03	0.16**	−0.19**	0.10	0.13*	−0.27**		−0.26**	−0.15*
10	0.10	−0.24**	−0.04	−0.07	0.22**	−0.05	0.08	0.12	−0.26**		0.32**
11	0.25**	−0.19**	−0.02	0.07	0.02	0.04	0.09	0.36**	−0.15*	0.32**

Notes:

* Correlation is significant at the 0.05 level (two-tailed).

** Correlation is significant at the 0.01 level (two-tailed).

Abbreviations: AMD, age-related macular degeneration; CSQ-8, Client Service Questionnaire; MacDQoL, macular disease-specific-related quality of life; MacTSQ, Macular Treatment Satisfaction Questionnaire; VAS, visual analog score.

Table 5 Hierarchical regression models predicting treatment satisfaction (MacTSQ) in patients with AMD treated with intravitreal ranibizumab

Model	Variable statistics full model		Model statistics
	Stand β	Sig	Block	ΔR^2	Adj R^2	R^2 change	F-change	P-value
Demographics
Carer sex	0.085	0.212
Age	−0.053	0.434
Living alone	−0.035	0.612	1	0.012	−0.002	0.012	0.87	0.466
Vision
VA better eye pre-therapy	0.039	0.573
NEI-VFQ	0.074	0.272
Duration AMD	0.211	0.002	2	0.059	0.033	0.048	3.666	0.013
Care and treatment
No injections	0.064	0.475
VA change	0.078	0.267
Care satisfaction (CSQ-8)	−0.228	0.001	3	0.122	0.085	0.063	5.117	0.002
Health-related QoL
EQ-5D-3L (index)	0.192	0.005	4	0.154	0.114	0.032	7.990	0.005

Abbreviations: AMD, age-related macular degeneration; CSQ-8, Client Service Questionnaire; MacTSQ, Macular Treatment Satisfaction Questionnaire; VA, visual acuity; NEI-VFQ-25, 25-item National Eye Institute Visual Function Questionnaire; QoL, quality of life; Sig, significance.