It goes without saying that one of the biggest risk factors of seeing any disease progress is loss to follow up (LTFU). When patients cease reporting to the clinic, their care is compromised. For patients with diabetic retinopathy (DR), monitoring any changes in the retinal vasculature is elemental to providing timely treatment. For these reasons, researchers in Boston have spent four years trying to catalog the signs that your patient is likely to be lost to follow up. “Identifying patients at high risk for LTFU may help in choosing treatment modality and appropriate patient counseling,” the researchers note in their paper on the study.
The team looked at the records of 418 patients from January 2014 to June 2018 at Boston University School of Medicine’s Department of Ophthalmology. Specifically, they narrowed in on the risk factors for loss to follow up in patients with proliferative DR (PDR) who were undergoing intravitreal injections of anti-VEGF, panretinal photocoagulation (PRP) or both.
In this study, 61% of patients were lost to follow up. The researchers identified several qualities that can be considered risk factors for losing patients to follow up. Those whose primary language isn’t English have nearly two times the risk of being lost to follow up, as do patients between the ages of 56 and 65. Patients older than 65 have a slightly higher risk yet. Patients with more than five comorbidities are 2.3 times more like to never return, and those who live more than 20 miles from the clinic are 2.7 times more likely to disappear from the schedule. Missing more than 10% of non–eye care appointments and receiving only PRP compared with only anti-VEGF injections are also risk factors, the research found.
|Green M, Tien T, Ness S. Predictors of loss to follow up in patients being treated for proliferative diabetic retinopathy. Am J Ophthalmol. March 31, 2020. [Epub ahead of print].|