Jimmy T Le1, Kareshma Mohanty2, Amanda K Bicket3, Michelle E Tarver4, Malvina Eydelman5, Tianjing Li6. 1. Department of Epidemiolog, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. 2. Department of Epidemiology, University of Maryland. 3. Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland, USA. 4. Office of the Center Director, Center for Devices and Radiological Health, United States Food and Drug Administration, White Oak, Maryland, USA. 5. Division of Ophthalmic and Ear, Nose and Throat Devices, Center for Devices and Radiological Health, United States Food and Drug Administration, White Oak, Maryland, USA. 6. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Abstract
Purpose: To explore patients' perspectives and experiences living with glaucoma and identify important benefits and risks that patients consider before electing for new glaucoma treatments, such as minimally invasive glaucoma surgical (MIGS) devices. Design: Semi-structured, in-person qualitative interviews with patients seen at the Johns Hopkins Wilmer Eye Institute. Participants: Adults older than 21 years of age who were suspected or diagnosed with ocular hypertension or mild to moderate primary open-angle glaucoma (POAG) (and thus eligible for treatment with a MIGS procedure) presenting to a glaucoma clinic in Baltimore, Maryland, between May and December 2016. Method: We conducted in-person interviews with patients recently diagnosed with ocular hypertension or POAG. We focused on considerations patients take into account when deciding between different treatments. We used the framework approach to code and analyze the qualitative data. Considerations of special interest to us were those that can be translated into outcomes (or endpoints) in clinical trials. Main outcome measures: Patients' perspectives concerning outcomes that matter to them when managing ocular hypertension or POAG. Results: Ten male and fifteen female patients participated in our study. The median participant age was 69 years (range 47 - 82 years). We identified outcomes that patients expressed as important, which we grouped into four thematic categories: (1) limitations in performing specific vision-dependent activities of daily living; (2) problems with general visual function or perceptions; (3) treatment burden, including ocular adverse events; and (4) intraocular pressure (IOP). All 25 participants expressed some concerns with their ability to perform vision-dependent activities, such as reading and driving. Most (23/25) participants had an opinion about IOP, and among those currently taking ocular hypotensive eye drops, all recognized the relationship between eye drops and IOP. Conclusion: We have identified outcomes that matter to patients who are deciding between different treatments for ocular hypertension and POAG, such as the ability to drive or maintain mobility outside the home. These outcomes will be important in future evaluations of new treatments for glaucoma.
Purpose: To explore patients' perspectives and experiences living with glaucoma and identify important benefits and risks that patients consider before electing for new glaucoma treatments, such as minimally invasive glaucoma surgical (MIGS) devices. Design: Semi-structured, in-person qualitative interviews with patients seen at the Johns Hopkins Wilmer Eye Institute. Participants: Adults older than 21 years of age who were suspected or diagnosed with ocular hypertension or mild to moderate primary open-angle glaucoma (POAG) (and thus eligible for treatment with a MIGS procedure) presenting to a glaucoma clinic in Baltimore, Maryland, between May and December 2016. Method: We conducted in-person interviews with patients recently diagnosed with ocular hypertension or POAG. We focused on considerations patients take into account when deciding between different treatments. We used the framework approach to code and analyze the qualitative data. Considerations of special interest to us were those that can be translated into outcomes (or endpoints) in clinical trials. Main outcome measures: Patients' perspectives concerning outcomes that matter to them when managing ocular hypertension or POAG. Results: Ten male and fifteen female patients participated in our study. The median participant age was 69 years (range 47 - 82 years). We identified outcomes that patients expressed as important, which we grouped into four thematic categories: (1) limitations in performing specific vision-dependent activities of daily living; (2) problems with general visual function or perceptions; (3) treatment burden, including ocular adverse events; and (4) intraocular pressure (IOP). All 25 participants expressed some concerns with their ability to perform vision-dependent activities, such as reading and driving. Most (23/25) participants had an opinion about IOP, and among those currently taking ocular hypotensive eye drops, all recognized the relationship between eye drops and IOP. Conclusion: We have identified outcomes that matter to patients who are deciding between different treatments for ocular hypertension and POAG, such as the ability to drive or maintain mobility outside the home. These outcomes will be important in future evaluations of new treatments for glaucoma.
Authors: Ian J Saldanha; Kristina Lindsley; Diana V Do; Roy S Chuck; Catherine Meyerle; Leslie S Jones; Anne L Coleman; Henry D Jampel; Kay Dickersin; Gianni Virgili Journal: JAMA Ophthalmol Date: 2017-09-01 Impact factor: 7.389
Authors: Rachel E Sherman; Kathleen M Davies; Melissa A Robb; Nina L Hunter; Robert M Califf Journal: Nat Rev Drug Discov Date: 2017-02-24 Impact factor: 84.694