title: Treatment satisfaction of patients with neovascular age-related macular degeneration treated with anti-vascular endothelial growth factor agents.
abstract: OBJECTIVE
  To assess the psychometric properties of the Greek Macular Disease Treatment Satisfaction Questionnaire (MacTSQ) and evaluate the factors that influence treatment satisfaction of patients with neovascular age-related macular degeneration (nAMD).
  
  
  METHODS
  The MacTSQ was translated into Greek and administered to 176 patients. All patients completed the SF-12 Health Survey and the Macular disease Dependent Quality of Life Questionnaire (MacDQoL) and underwent vision measurements. For test-retest reliability, a subset of 19 participants completed the MacTSQ twice, two weeks apart. Stepwise multiple linear regression analyses were performed to identify predictors of treatment satisfaction. Change in MacTSQ scores over time was assessed on 83 patients who completed the MacTSQ at a follow-up visit, one year later.
  
  
  RESULTS
  The intraclass correlation coefficients between the first and second test-retest administration ranged from 0.88 to 0.98 for the items and total score. Internal reliability of the total score was adequate (Cronbach's a = 0.837). Principal component analysis revealed three subscales (effectiveness, information provision and convenience, impact). The MacTSQ score showed significant correlations with SF-12 summary scales and MacDQoL scores (ρ = 0.16-0.27). The most important factor that determined the satisfaction was mental health. Distance visual acuity (VA) in better eye was the best predictor of the effectiveness subscale, and the total number of injections was a negative predictor for the convenience subscale. Treatment satisfaction increased at one-year follow-up, despite the deterioration in distance VA.
  
  
  CONCLUSIONS
  The Greek MacTSQ is a reliable and valid instrument for assessing nAMD patients' perceptions of treatment satisfaction, especially using its three new subscales. Treatment satisfaction is multifactorial and was primarily determined by patients' mental health status.
authors.affiliation: First Department of Ophthalmology, University of Athens Medical School, Athens General Hospital "G. Gennimatas", Athens, Greece. theomarakis@yahoo.gr.
authors.forename: Theodoros P
authors.initials: TP
authors.lastname: Marakis
authors.affiliation: First Department of Ophthalmology, University of Athens Medical School, Athens General Hospital "G. Gennimatas", Athens, Greece.
authors.forename: Chrysanthi
authors.initials: C
authors.lastname: Koutsandrea
authors.affiliation: First Department of Ophthalmology, University of Athens Medical School, Athens General Hospital "G. Gennimatas", Athens, Greece.
authors.forename: Klio I
authors.initials: KI
authors.lastname: Chatzistefanou
authors.affiliation: Department of Hygiene and Epidemiology, Center for Health Services Research, University of Athens Medical School, Athens, Greece.
authors.forename: Yannis
authors.initials: Y
authors.lastname: Tountas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D020256:Choroidal Neovascularization / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011594:Psychometrics; D011788:Quality of Life; D000069579:Ranibizumab / Q000627:therapeutic use; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; D042461:Vascular Endothelial Growth Factor A; D000069579:Ranibizumab
keywords: Age-related macular degeneration; Greece; Predictors; Psychometric properties; Treatment satisfaction questionnaire