![]() ![]() The human ethics committees at the Colorado Multiple Institutional Review Board approved the study. HUMAN SUBJECTS: Human subjects were included in this study. The funding organization had no role in the design or conduct of this research. Supported in part by Research to Prevent Blindness, Inc., New York, New York (challenge grant to the University of Colorado Department of Ophthalmology). The test–retest reliability and validity of the questionnaire were not assessed.įinancial Disclosure(s): The author(s) have made the following disclosure(s): L.K.S.: Financial support - Allergan, New World Medical Alcon, Glaukos. ![]() However, if questions arose during a survey, attempts at clarification were made to help mitigate this factor. Theoretically, questions above this benchmark unknowingly can lead to confusion among respondents. The questionnaire was not verified formally by the Flesch-Kincaid Grade Level Score for sixth- to eighth-grade level comprehension. A perceived inconvenience of more visits remains susceptible to poor external validity and is highly dependent on local access to care. Because almost all patients had undergone prior ocular surgery and, based on inclusion criteria, all had received an IVI in the past, these results likely cannot be generalized to patients who have never undergone any type of ocular procedure. We understand the subjectivity associated with patient perception of improved efficacy as well as the variation in patient perception of pain and fear of procedure. Although efforts were made to ensure patient understanding and cooperation, it is possible that some patients did not understand fully the concept of IVI and the theoretical scenarios of reduced frequency and increased efficacy. This study is limited by a small sample size drawn from a single tertiary referral center with patients from a large geographic distribution. All statistical analysis was performed in RStudio (Boston, MA) in consultation with a biostatistician. A P value less than 0.05 was considered statistically significant for any association. The association between these groups and injection preference was analyzed using the Fisher exact test. Additionally, participants were stratified into 2 groups consisting of patients using 1 topical medication and those using 2 or more topical medications. Using Fisher exact tests, these groups were compared for their injection preference at a theoretical equal and improved efficacy. For age, participants were categorized into 3 cohorts: younger than 60 years of age, 60 to 80 years of age, and older than 80 years. Variables assessed included equal or hypothetically improved efficacy, hypothetical dosing intervals, race, ethnicity, reason for receiving prior IVI, type of glaucoma, severity of glaucoma, and previous ocular surgeries. A Fisher exact test was used to test the significance of association between categorical variables and injection preference. The demographic features of patients meeting inclusion criteria but who either could not be reached or declined to participate in the survey were used as a control group to ensure that the demographic features of those who participated were similar to those of the entire group. Fisher exact tests were used to test associations between categorical variables. ![]() The associations between patients’ responses to questionnaires and each outcome measure were assessed. Each patient’s reasons for preferring topical drops or injections also were recorded. Patients were surveyed regarding their theoretical willingness to undergo IVI for glaucoma with once-monthly frequency assuming equal efficacy to a topical regimen, less than once-monthly frequency and the same efficacy as a topical regimen, and greater efficacy than a topical regimen with monthly injections. Past or current glaucoma and injection regimens and side effects were collected from patient responses. Our questionnaire was developed by 4 of the study authors (L.K.S., M.B.P., M.Y.K., and J.R.S.) who are fellowship-trained glaucoma specialists and was not validated because of the size and nature of the planned study. Patient preferences were determined by a 10-item questionnaire delivered by a trained interviewer who was not involved with the patient’s care ( Fig 1). The patient’s type of glaucoma, glaucoma severity, reason for IVI, and previous ocular surgeries were collected by chart review. Demographic data collected included age, gender, race, and ethnicity.
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