Same-Day Treatments Preferred in Patients Receiving Anti-VEGF Therapy

Results of a new study show that receiving same day intravitreal anti-VEGF treatments was highly preferred among patient populations that were disabled, elderly, or traveling long-distance.




The study, which was presented at the 2019 American Society of Retina Specialists Annual Meeting, included more than 230 patients and was conducted by investigators from the University of Minnesota.

In response to push from insurance companies and federal agencies to reform Modifier-25, which could result in loss of coverage or reimbursement, investigators sought to determine the frequency and reasoning behind patients preferring intravitreal injections the same day as examination. Citing that a change in policy could result in additional visits, which investigators fear could lead to lower compliance, investigators conducted a survey of 238 patients to gauge preference of treatment and, if same day was preferred, the reason behind that preference. 



Patients included in the study ranged in age from 33 years old to 97 years old and came from rural and urban areas of Minnesota. All patients were asked to complete a standardized questionnaire. Investigators recorded information relating to patient treatment, retinal diseases, comorbid eye conditions, temporal preference for treatment and socioeconomic factors.

Investigators analyzed the proportion of patients with same day preference versus separate day treatments for their specific retinal disease or diseases and determined the factors that influenced their choice of preference. Total visit time as reported by patients, which included transportation, was compared to calculations from electronic medical records, demographic reports, and a web-based map.

Investigators found that 97.5% (232) of all surveyed patients preferred same-day injections while just 6 patients preferred separate day injections. Of the 6 patients who preferred separate day treatments, none of them were visually disabled and only 1 had a mobility impairment.

The average age among the same day group was 77 years compared to 80 years in the separate day arm. Of those who preferred same day treatments, 26.7% were physically disabled and 14.2% had visual impairment compared to 16.7% and 0%, respectively, in the separate day group.

The most common reason for preferring treatments the same day as evaluation was transportation issues (56.6%), followed by time (41.1%), and then cost (2.2%). 



“As a physician I’d probably use this data to defend Modifier-25. If I’m seeing older patients, more disabled patients and they’re preferring same-day treatments and you’d think it was the cost but what we found is it’s really the mobility,” said presenter Loi Vo, MS, clinical research at the Retina Center of Minnesota, in an interview with MD Magazine® at ASRS 2019. 



This study, titled “Same Day Intravitreal Anti-VEGF Treatments Highly Preferred in Elderly, Disabled, and Long-Distance Traveling Patients,” was presented at ASRS 2019.