Management of Wet Age-Related Macular Degeneration in Spain: Challenges for Treat and Extend Implementation in Routine Clinical Practice
Purpose. To ascertain wet AMD (wAMD) management patterns in Spain. Methods. A two-round Delphi study conducted through a questionnaire-based survey designed from literature review and validated by an independent Steering Committee. Results. Forty-nine retina specialists experienced in wAMD participa...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Journal of Ophthalmology |
| Online Access: | http://dx.doi.org/10.1155/2019/9821509 |
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| author | A. García-Layana J. García-Arumí M. S. Figueroa L. Arias Barquet J. M. Ruíz-Moreno L. Monclús-Arbona The Spanish AMD Multicenter Group |
| author_facet | A. García-Layana J. García-Arumí M. S. Figueroa L. Arias Barquet J. M. Ruíz-Moreno L. Monclús-Arbona The Spanish AMD Multicenter Group |
| author_sort | A. García-Layana |
| collection | DOAJ |
| description | Purpose. To ascertain wet AMD (wAMD) management patterns in Spain. Methods. A two-round Delphi study conducted through a questionnaire-based survey designed from literature review and validated by an independent Steering Committee. Results. Forty-nine retina specialists experienced in wAMD participated by answering the two-round study questionnaire. Retina specialists are the main responsible for wAMD diagnosis and monitoring, including visits and associated procedures, with a median time per visit of 15 minutes. Standard treatment strategies are based on anti-VEGF administration, including standard loading dose administration followed by maintenance with aflibercept or ranibizumab (81% of patients). Although treat and extend (T&E) dosing strategy is considered as optimal for wAMD management (78% of the panelists), the main routine healthcare limitations (i.e., visits overload, reduced staff, short visit time, coordination issues, lack of facilities) conduct to self-defined “flexible” strategies, based on T&E and pro-re-nata (PRN) protocols. Conclusion. Proactive treatment patterns (T&E) are the preferred ones by the retina specialists in Spain. However, their proper implementation is difficult due to healthcare resource limitations, as well as organisation and logistic issues. The use of anti-VEGF agents with longer duration of action could facilitate the use of strict T&E approaches according to routine clinical practices. |
| format | Article |
| id | doaj-art-5347d3ec10d049ef93e100da08d8349b |
| institution | Kabale University |
| issn | 2090-004X 2090-0058 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Ophthalmology |
| spelling | doaj-art-5347d3ec10d049ef93e100da08d8349b2025-02-03T01:11:19ZengWileyJournal of Ophthalmology2090-004X2090-00582019-01-01201910.1155/2019/98215099821509Management of Wet Age-Related Macular Degeneration in Spain: Challenges for Treat and Extend Implementation in Routine Clinical PracticeA. García-Layana0J. García-Arumí1M. S. Figueroa2L. Arias Barquet3J. M. Ruíz-Moreno4L. Monclús-Arbona5The Spanish AMD Multicenter Group6Clínica Universidad de Navarra, Avenida de Pío XII 36, 31008 Pamplona, SpainHospital de la Vall d’Hebrón, Passeig de la Vall d’Hebrón 119-129, 08035 Barcelona, SpainVissum Madrid, Santa Hortensia 58, 28002 Madrid, SpainHospital de Bellvitge, C/ Feixa Llarga s/n, L’Hospitalet de Llobregat, 08907 Barcelona, SpainHospital Universitario Puerta de Hierro-Majadahonda, Joaquín Rodrigo, 2, 28222 Madrid, SpainBayer Hispania, S.L., Av. Baix Llobregat, 3-5, 08970 Sant Joan Despí, Barcelona, SpainIQVIA Information, Barcelona, SpainPurpose. To ascertain wet AMD (wAMD) management patterns in Spain. Methods. A two-round Delphi study conducted through a questionnaire-based survey designed from literature review and validated by an independent Steering Committee. Results. Forty-nine retina specialists experienced in wAMD participated by answering the two-round study questionnaire. Retina specialists are the main responsible for wAMD diagnosis and monitoring, including visits and associated procedures, with a median time per visit of 15 minutes. Standard treatment strategies are based on anti-VEGF administration, including standard loading dose administration followed by maintenance with aflibercept or ranibizumab (81% of patients). Although treat and extend (T&E) dosing strategy is considered as optimal for wAMD management (78% of the panelists), the main routine healthcare limitations (i.e., visits overload, reduced staff, short visit time, coordination issues, lack of facilities) conduct to self-defined “flexible” strategies, based on T&E and pro-re-nata (PRN) protocols. Conclusion. Proactive treatment patterns (T&E) are the preferred ones by the retina specialists in Spain. However, their proper implementation is difficult due to healthcare resource limitations, as well as organisation and logistic issues. The use of anti-VEGF agents with longer duration of action could facilitate the use of strict T&E approaches according to routine clinical practices.http://dx.doi.org/10.1155/2019/9821509 |
| spellingShingle | A. García-Layana J. García-Arumí M. S. Figueroa L. Arias Barquet J. M. Ruíz-Moreno L. Monclús-Arbona The Spanish AMD Multicenter Group Management of Wet Age-Related Macular Degeneration in Spain: Challenges for Treat and Extend Implementation in Routine Clinical Practice Journal of Ophthalmology |
| title | Management of Wet Age-Related Macular Degeneration in Spain: Challenges for Treat and Extend Implementation in Routine Clinical Practice |
| title_full | Management of Wet Age-Related Macular Degeneration in Spain: Challenges for Treat and Extend Implementation in Routine Clinical Practice |
| title_fullStr | Management of Wet Age-Related Macular Degeneration in Spain: Challenges for Treat and Extend Implementation in Routine Clinical Practice |
| title_full_unstemmed | Management of Wet Age-Related Macular Degeneration in Spain: Challenges for Treat and Extend Implementation in Routine Clinical Practice |
| title_short | Management of Wet Age-Related Macular Degeneration in Spain: Challenges for Treat and Extend Implementation in Routine Clinical Practice |
| title_sort | management of wet age related macular degeneration in spain challenges for treat and extend implementation in routine clinical practice |
| url | http://dx.doi.org/10.1155/2019/9821509 |
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