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Treatment satisfaction of patients with neovascular age-related macular degeneration treated with anti-vascular endothelial growth factor agents

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Abstract

Purpose

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.

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Acknowledgements

The authors would like to thank all the patients with age-related macular degeneration who participated in this study and the optometrist A Nikolopoulou for her valuable assistance. We are grateful to the developer of the MacTSQ Professor Clare Bradley for granting us permission to use the instrument in our study. For access to the MacTSQ and MacDQoL questionnaires in the original English, Greek or other languages, visit www.healthpsychologyresearch.com. The SF-12 Health Survey is currently available in multiple language translations. For access, visit www.optum.com/optum-outcomes.

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Authors and Affiliations

  1. First Department of Ophthalmology, University of Athens Medical School, Athens General Hospital “G. Gennimatas”, Athens, Greece

    Theodoros P. Marakis, Chrysanthi Koutsandrea & Klio I. Chatzistefanou

  2. Department of Hygiene and Epidemiology, Center for Health Services Research, University of Athens Medical School, Athens, Greece

    Yannis Tountas

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  1. Theodoros P. Marakis
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  2. Chrysanthi Koutsandrea
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  3. Klio I. Chatzistefanou
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Correspondence to Theodoros P. Marakis.

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Patient consent

Informed consent was obtained from all individual participants included in the study.

Research involving human participants

All procedures performed in our study were in accordance with the ethical standards of the Athens General Hospital “G. Gennimatas” research committee (No 27130, 4/11/2011) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Marakis, T.P., Koutsandrea, C., Chatzistefanou, K.I. et al. Treatment satisfaction of patients with neovascular age-related macular degeneration treated with anti-vascular endothelial growth factor agents. Int Ophthalmol 38, 565–576 (2018). https://doi.org/10.1007/s10792-017-0492-8

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  • DOI: https://doi.org/10.1007/s10792-017-0492-8

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