Patient perspectives and barriers in the treatment of neovascular age-related macular degeneration in Denmark: a qualitative study

Abstract

Objectives This qualitative study aims to identify patient-reported barriers to treatment for neovascular age-related macular degeneration (nAMD) and investigate their impact on quality of life.Design Using a qualitative explorative design.Setting Semi-structured individual or dyadic interviews were conducted with patients and their relatives.Participants Twenty-one patients completed the interview, with four of them having a relative present.Interventions Gadamer’s hermeneutics guided the epistemological approach, and maximum variation sampling was employed to capture diverse patient experiences. An advisory board consisting of patients, relatives and ophthalmologists ensured the relevance of the study. Thematic analysis was conducted using NVivo software.Primary and secondary outcome measures To investigate patient-reported barriers to the recommended treatment for nAMD and impact on quality of life.Results The study included 21 patients with nAMD, with a median age of 79 years. Five themes emerged: (1) good compliance with intravitreal treatment, (2) the dual role of relatives, (3) treatment commute, (4) hospital barriers, (5) preventive health literacy.Conclusion This study highlights the resilience and adherence of patients with nAMD in Denmark to their treatment despite various barriers. While the therapy may have negative effects on their well-being, patients do not opt out of treatment. These findings underscore the importance of personalised treatment plans that provide, for example, convenient access to care and clear future agreements at the hospital. By adopting more patient-centred approaches, healthcare providers can enhance patient satisfaction and improve treatment adherence, ultimately leading to better patient outcomes and quality of life.