Impact of a more stringent organization of intravitreal injection treatment on the number of treatments and examinations in routine practice

• Published in: Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft 2021-11, Vol.118 (11), p.1134-1139
• Main Authors: Glück, S, Brandlhuber, U, Gerbutavicius, R, Kortüm, G-F, Kortüm, I, Navarrete Orozco, R, Rakitin, M, Strodtbeck, M, Kortüm, K
• Format: Article
• Language: ger
• Subjects: Angiogenesis Inhibitors - therapeutic use; Follow-Up Studies; Humans; Intravitreal Injections; Ranibizumab; Retrospective Studies; Tomography, Optical Coherence; Treatment Outcome
• ISSN: 1433-0423
• DOI: 10.1007/s00347-020-01267-3

Results from recent studies show that less intravitreal injections are often performed in everyday practice than in controlled trials, which subsequently leads to worse treatment success. In this study we analyzed the introduction of a more stringent organization of treatment using workflow optimization and new IT systems and analyzed the effect on treatment continuity. In the second quarter of 2019 a new medical practice management software and a software for automated injection planning were implemented. There was also a change of the treatment regimen from pro re nata (PRN) to treat and extend (T&E ). We analyzed the results of the patients regarding the frequency of injections and treatment controls three quarters before (Q3/2018-Q1/2019) and three quarters after the change (Q2/2019-Q4/2019). Treatment-naive and pretreated patients were analyzed. In group 1 (Q3/2018-Q1/2019) the average number of injections per quarter was 1.74 (SD = 0.4). Eyes of patients from group 2 (Q2/2019-Q4/2019) received on average 2.17 (SD = 0.3) injections. The number of check-ups per quarter was 1.71 (SD = 0.3) before the introduction, and thereafter 2.16 (SD = 0.3). There was a significant increase in the number of OCTs from 1.18 (SD = 0.2) to 1.98 (SD = 0.3). The visual acuity was stable in both groups. We were able to show that the introduction of the medical practice management software and the change of the regimen from PRN to T&E can achieve numbers of injections, check-ups and OCT similar to those in studies. A standardized procedure facilitates efficient treatment planning and enables a better patient management.