title: Determining patient preferences in the management of neovascular age-related macular degeneration: a conjoint analysis.
abstract: PurposeTo determine the opinions from a patient perspective on relevant variables in the delivery of treatment for neovascular age-related macular degeneration (nAMD).MethodsPilot interviews with patients and doctors were conducted to identify what variables in the provision of a nAMD service were important. This led to the generation of two sets of scenario options. Subsequently 100 patients undergoing active treatment for nAMD in the National Health Service University Hospital, United Kingdom underwent interview assessment. They were asked to rank their preferences for provision of their care with reference to these two sets of scenario options. Using conjoint analysis, percentage preferences, and utility scores for each variable in each scenario design were calculated.ResultsNinety-five patients completed the preference ranking for both scenarios. Eight patients ranked worse vision as preferable to better vision and were excluded on the basis that they had not understood the task. The results of the remaining 87 patients are presented. The most important factor to patients was having good vision, followed by a one-stop service and less frequent follow up. The least important factors were label status of the drug, cost to the health service, and grade of the injector.ConclusionPatients regard good vision and minimal visits to the hospital above the status of injector, label status of drug, or cost to the NHS.
authors.affiliation: Department of Ophthalmology, Queens Medical Centre, Nottingham, UK.
authors.forename: J M
authors.initials: JM
authors.lastname: Baxter
authors.affiliation: Department of Ophthalmology, Queens Medical Centre, Nottingham, UK.
authors.forename: A J
authors.initials: AJ
authors.lastname: Fotheringham
authors.affiliation: Department of Ophthalmology, Queens Medical Centre, Nottingham, UK.
authors.forename: A J E
authors.initials: AJ
authors.lastname: Foss
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000627:therapeutic use; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D019468:Disease Management; D005260:Female; D017048:Health Care Costs; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D057240:Patient Preference / Q000706:statistics & numerical data*; D000069579:Ranibizumab / Q000627:therapeutic use; D013222:State Medicine; D061665:Time-to-Treatment; D006113:United Kingdom; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014786:Vision Disorders / Q000188:drug therapy* / Q000503:physiopathology; D014850:Waiting Lists; D057135:Wet Macular Degeneration / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D020533:Angiogenesis Inhibitors; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D000069579:Ranibizumab