Healthcare utilization and treatment patterns in diabetic macular edema in Korea: A retrospective chart review

Kyu Hyung Park, Yun Young Kim, Young Joon Jo, Jae Ryung Oh, Joo Eun Lee, Ji Eun Lee, Dong Ho Park, Se Woong Kang, Won Ki Lee, Ha Kyoung Kim, Michael Adena, Jonathan Tan, Si Dong Kim

Research output: Contribution to journalArticle

2 Citations (Scopus)

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.

Original languageEnglish
Article numbere118
JournalJournal of Korean medical science
Volume34
Issue number15
DOIs
Publication statusPublished - 2019 Apr 22

Fingerprint

Macular Edema
Korea
Delivery of Health Care
Vascular Endothelial Growth Factor A
Visual Acuity
Therapeutics
Injections
Laser Therapy
Ophthalmology
Ambulatory Care
Adrenal Cortex Hormones
Lasers
Demography
Clinical Trials

Keywords

  • Anti-VEGF
  • Clinical practice patterns
  • Intravitreal injections
  • Laser therapy
  • Visual acuity
  • Visual outcomes

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Healthcare utilization and treatment patterns in diabetic macular edema in Korea : A retrospective chart review. / Park, Kyu Hyung; Kim, Yun Young; Jo, Young Joon; Oh, Jae Ryung; Lee, Joo Eun; Lee, Ji Eun; Park, Dong Ho; Kang, Se Woong; Lee, Won Ki; Kim, Ha Kyoung; Adena, Michael; Tan, Jonathan; Kim, Si Dong.

In: Journal of Korean medical science, Vol. 34, No. 15, e118, 22.04.2019.

Research output: Contribution to journalArticle

Park, KH, Kim, YY, Jo, YJ, Oh, JR, Lee, JE, Lee, JE, Park, DH, Kang, SW, Lee, WK, Kim, HK, Adena, M, Tan, J & Kim, SD 2019, 'Healthcare utilization and treatment patterns in diabetic macular edema in Korea: A retrospective chart review', Journal of Korean medical science, vol. 34, no. 15, e118. https://doi.org/10.3346/jkms.2019.34.e118
Park, Kyu Hyung ; Kim, Yun Young ; Jo, Young Joon ; Oh, Jae Ryung ; Lee, Joo Eun ; Lee, Ji Eun ; Park, Dong Ho ; Kang, Se Woong ; Lee, Won Ki ; Kim, Ha Kyoung ; Adena, Michael ; Tan, Jonathan ; Kim, Si Dong. / Healthcare utilization and treatment patterns in diabetic macular edema in Korea : A retrospective chart review. In: Journal of Korean medical science. 2019 ; Vol. 34, No. 15.
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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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T2 - A retrospective chart review

AU - Park, Kyu Hyung

AU - Kim, Yun Young

AU - Jo, Young Joon

AU - Oh, Jae Ryung

AU - Lee, Joo Eun

AU - Lee, Ji Eun

AU - Park, Dong Ho

AU - Kang, Se Woong

AU - Lee, Won Ki

AU - Kim, Ha Kyoung

AU - Adena, Michael

AU - Tan, Jonathan

AU - Kim, Si Dong

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Y1 - 2019/4/22

N2 - 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.

AB - 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.

KW - Anti-VEGF

KW - Clinical practice patterns

KW - Intravitreal injections

KW - Laser therapy

KW - Visual acuity

KW - Visual outcomes

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