J Korean Med Sci.
2019 Apr;34(15):e118. 10.3346/jkms.2019.34.e118.
Healthcare Utilization and Treatment Patterns in Diabetic Macular Edema in Korea: a Retrospective Chart Review
- Affiliations
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- 1Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
- 2Department of Ophthalmology, Daegu Catholic University Medical Center, Daegu, Korea. sdkim1@cu.ac.kr
- 3Department of Ophthalmology, Chungnam National University Hospital, Daejeon, Korea.
- 4Department of Ophthalmology, Korea University Anam Hospital, Seoul, Korea.
- 5J Eye Center, Busan, Korea.
- 6Department of Ophthalmology, Pusan National University Hospital, Busan, Korea.
- 7Department of Ophthalmology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea.
- 8Department of Ophthalmology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea.
- 9Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
- 10Department of Ophthalmology, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea.
- 11Datalytics Pty Ltd, Canberra, Australia.
- 12Allergan Singapore Pte. Ltd, Singapore.
- KMID: 2443206
- DOI: http://doi.org/10.3346/jkms.2019.34.e118
Abstract
- BACKGROUND
Limited data exist on real-world treatment patterns for diabetic macular edema (DME) in Korea. In this study, we investigated DME treatment patterns from 2009 to 2014 and the impact of baseline treatment on healthcare resource utilization and visual acuity (VA) outcomes.
METHODS
A retrospective cohort chart review of DME patients treated at 11 hospital ophthalmology clinics between January 1, 2012 and December 31, 2013 was conducted. We collected data on demographics, healthcare resource utilization (clinic visits, treatment visits, and visits for ocular investigations), distribution of DME treatments, and VA.
RESULTS
Overall, 522 DME patients (men, 55.2%; mean age, 59 years; mean HbA1c [n = 209], 8.4%) with 842 DME eyes were evaluated. For all treatments, healthcare resource utilization was significantly higher during the first 6 months versus months 7-12, year 2, or year 3 (P ≤ 0.001), but was highest for patients whose first treatment was an anti-vascular endothelial growth factor (VEGF) treatment (visits/quarter; anti-VEGF, 1.9; corticosteroids, 1.7; laser, 1.4). Use of macular laser therapy decreased (44% to 8%), whereas use of anti-VEGF injections increased (44% to 69%) during the study period. However, VA improvement was not commensurate with healthcare resource utilization of anti-VEGF treatment (mean VA gain, 2.7 letters).
CONCLUSION
A trend toward increasing use of intravitreal anti-VEGF injections for DME treatment was observed in Korea. However, the frequency of dosing and monitoring was lower in clinical practice versus major clinical trials, which may have led to the less-than-favorable improvements in visual outcomes.
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