Abstract
PurposeTo assess the caregiver burden and factors determining the burden in patients receiving ranibizumab therapy for neovascular AMD (nAMD).MethodsThis is a cross-sectional questionnaire survey of 250 matched patient caregiver dyads across three large ophthalmic treatment centres in United Kingdom. The primary outcome was the subjective caregiver burden measured using caregiver reaction assessment scale (CRA). Objective caregiver burden was determined by the caregiver tasks and level of care provided. The factors that may predict the caregiver burden such as the patient’s visual acuity of the better eye and vision related quality of life, demographics, satisfaction and support provided by the healthcare and the health status of the dyads were also collected and assessed in a hierarchical regression model.ResultsThe mean CRA score was 3.2±0.5, similar to the score reported by caregivers for atrial fibrillation who require regular hospital appointments for monitoring their thromboprophylaxis. Caregiver tasks including accompanying for hospital appointments for eye treatment and patient’s visual acuity in the better eye were the biggest contributors to the caregiver burden hierarchical model explaining 18% and 11% of the variance respectively.ConclusionRanibizumab therapy for nAMD is associated with significant caregiver burden. Both disease impact and treatment frequency contributed to the overall burden.
Highlights
Advanced age related macular degeneration (AMD) is a common cause of visual impairment in the older population.[1]
Caregiver tasks including accompanying for hospital appointments for eye treatment and patient’s visual acuity in the better eye were the biggest contributors to the caregiver burden hierarchical model explaining 18% and 11% of the variance respectively
Ranibizumab therapy for neovascular AMD (nAMD) is associated with significant caregiver burden
Summary
This cross-sectional questionnaire-based survey was conducted on 250 patient-caregiver pairs from 3 public ophthalmic treatment centres in the United Kingdom Patient participants were included if they had 6 months of follow-up after initiation of ranibizumab therapy, this ensured that all caregivers had been supporting the patients following a minimum treatment exposure. The proportions of patients with caregivers in each clinic and the pairs approached were ascertained to assess the response rate. Was evaluated using the validated Caregiver Reaction Assessment (CRA).[13] The CRA has been used extensively with family caregiver populations including elderly population with good internal consistency and content and construct validity testing.[14, 15] The instrument is a simple self-rated burden scale consisting of 24 items representing 5 dimensions of the caregiving situation. Higher scores on the negative dimensions represent higher levels of perceived burden (the exception to this is the self- esteem scale, for the purpose of our analysis we inverted this scale for consistency of interpretation). We tested the Cronbach α values for each scale and these ranged from 0.62 and 0.83 for the separate subscales
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