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Background <p>Neovascular age-related macular degeneration (nAMD) is a leading cause of irreversible visual impairment among older adults. Although intravitreal anti–vascular endothelial growth factor (anti-VEGF) therapy has improved visual outcomes, real-world effectiveness is often limited by poor adherence and treatment discontinuation. This study evaluated the impact of a structured patient engagement program on treatment adherence, injection persistence, visual outcomes, and patient-reported outcomes in patients receiving anti-VEGF therapy for nAMD.</p> Methods <p>This single-center retrospective observational comparative cohort study included 350 patients with nAMD treated between January 2022 and December 2024. Patients received either standard care alone (<i>n</i> = 175) or standard care plus a structured patient engagement program (<i>n</i> = 175) incorporating individualized education, adherence counseling, appointment reminders, and proactive follow-up communication. Primary outcomes were treatment adherence and injection persistence. Secondary outcomes included best-corrected visual acuity (BCVA), patient satisfaction, and disease understanding.</p> Results <p>Patients enrolled in the engagement program demonstrated significantly better adherence than those receiving standard care. The mean number of missed injection visits was lower (0.51 ± 0.68 vs. 1.48 ± 1.27; <i>P</i> &lt; 0.001), and delayed injections exceeding two weeks were less frequent (22.3% vs. 50.9%; <i>P</i> &lt; 0.001). Good adherence was achieved in 89.1% of patients in the engagement group compared with 50.3% in the standard care group (<i>P</i> &lt; 0.001), while treatment persistence was higher (90.9% vs. 77.7%; <i>P</i> = 0.001). Final BCVA was significantly better in the engagement group (0.61 ± 0.30 vs. 0.70 ± 0.34 LogMAR; <i>P</i> = 0.015), and a greater proportion of patients experienced visual improvement (65.1% vs. 52.6%; <i>P</i> = 0.023). Patient satisfaction and disease understanding were also significantly higher among patients receiving the engagement intervention (<i>P</i> &lt; 0.001 for both). Safety outcomes were comparable between groups.</p> Conclusions <p>A structured patient engagement program was associated with improved treatment adherence, enhanced injection persistence, and better short- to mid-term visual outcomes in patients receiving anti-VEGF therapy for nAMD. These findings support the integration of patient-centered engagement strategies into routine retinal care to optimize real-world treatment outcomes.</p>

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Impact of a structured patient engagement program on treatment adherence, injection persistence, and visual outcomes in real-world anti-VEGF therapy for neovascular age-related macular degeneration

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月20日

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  • Lixia Lan,
  • Jianhua Lan,
  • Xuan Ren,
  • Bo Ye

摘要

Background

Neovascular age-related macular degeneration (nAMD) is a leading cause of irreversible visual impairment among older adults. Although intravitreal anti–vascular endothelial growth factor (anti-VEGF) therapy has improved visual outcomes, real-world effectiveness is often limited by poor adherence and treatment discontinuation. This study evaluated the impact of a structured patient engagement program on treatment adherence, injection persistence, visual outcomes, and patient-reported outcomes in patients receiving anti-VEGF therapy for nAMD.

Methods

This single-center retrospective observational comparative cohort study included 350 patients with nAMD treated between January 2022 and December 2024. Patients received either standard care alone (n = 175) or standard care plus a structured patient engagement program (n = 175) incorporating individualized education, adherence counseling, appointment reminders, and proactive follow-up communication. Primary outcomes were treatment adherence and injection persistence. Secondary outcomes included best-corrected visual acuity (BCVA), patient satisfaction, and disease understanding.

Results

Patients enrolled in the engagement program demonstrated significantly better adherence than those receiving standard care. The mean number of missed injection visits was lower (0.51 ± 0.68 vs. 1.48 ± 1.27; P < 0.001), and delayed injections exceeding two weeks were less frequent (22.3% vs. 50.9%; P < 0.001). Good adherence was achieved in 89.1% of patients in the engagement group compared with 50.3% in the standard care group (P < 0.001), while treatment persistence was higher (90.9% vs. 77.7%; P = 0.001). Final BCVA was significantly better in the engagement group (0.61 ± 0.30 vs. 0.70 ± 0.34 LogMAR; P = 0.015), and a greater proportion of patients experienced visual improvement (65.1% vs. 52.6%; P = 0.023). Patient satisfaction and disease understanding were also significantly higher among patients receiving the engagement intervention (P < 0.001 for both). Safety outcomes were comparable between groups.

Conclusions

A structured patient engagement program was associated with improved treatment adherence, enhanced injection persistence, and better short- to mid-term visual outcomes in patients receiving anti-VEGF therapy for nAMD. These findings support the integration of patient-centered engagement strategies into routine retinal care to optimize real-world treatment outcomes.