The COVID-19 Pandemic and Ophthalmic Care: A Qualitative Study of Patients with Neovascular Age-Related Macular Degeneration (nAMD)

  1. Seán O’Connor
  2. Charlene Treanor
  3. Elizabeth Ward
  4. Robin Wickens
  5. Abby O’Connell
  6. Lucy Culliford
  7. Chris Rogers
  8. Eleanor Gidman
  9. Tunde Peto
  10. Paul Knox
  11. Benjamin Burton
  12. Andrew Lotery
  13. Sobha Sivaprasad
  14. Barnaby Reeves
  15. Ruth Hogg
  16. Michael Donnelly
  17. MONARCH Study Group

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Abstract

Concerns have been expressed about the relationship between reduced levels of health care utilisation and the COVID-19 pandemic. This study aimed to elicit and explore the views of patients with neovascular age-related macular degeneration (nAMD) regarding the COVID-19 pandemic and their ophthalmic care. Semi-structured telephone interviews were conducted with thirty-five patients with nAMD taking part in a larger diagnostic accuracy study of home-monitoring tests. Participants were recruited using maximum variation sampling to capture a range of key characteristics including age, gender and time since initial treatment. Transcribed interview data were analysed using a deductive and inductive thematic approach. Three themes emerged from the analysis: i. access to eye clinic care. ii. COVID-19-mitigating factors and care delivery and iii. social and personal circumstances. Participants reported anxieties about cancelled or delayed appointments, limited communication from clinic-based services about appointments, and the impact of this on their ongoing care. Despite these concerns, there was apprehension about attending appointments due to infection risk and a perception that nAMD patients are a ‘high risk’ group. Views of those who attended clinics during the study period were, however, positive, with social distancing and infection control measures providing reassurance. These findings contribute to our understanding about experiences of patients with nAMD during the COVID-19 pandemic and may have potential implications for future planning of care services in similar circumstances. Innovative approaches may be required to address issues related to access to care, including concerns about delayed or cancelled appointments.

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  1. Version published to 10.3390/ijerph19159488
  2. ScreenIT

    SciScore for 10.1101/2021.09.01.21262696: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsConsent: Informed consent to participate in the study was obtained verbally prior to interviews and following a full explanation of study procedures.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    A potential limitation of the study is that use of remote telephone interviews may provide different information than would be gathered using face-to-face interviews.26,27 This method was however, precluded because of the COVID-19 pandemic and associated social distancing measures. The study was also based on interviews conducted with participants taking part in an ongoing diagnostic accuracy study. Questions around the impact of COVID-19 were therefore not the only focus of the interviews and the responses may have been less in depth than if they related only to COVID-19. While participants were recruited to the study using maximum variation sampling methods (to ensure a balance of important patient characteristics), the sample may also not be reflective of all patients with nAMD. Participants were also recruited from sites within the UK and findings may not be applicable to other healthcare systems. Another limitation is that interviews could have been influenced by the different phases of the pandemic at which the interviews were conducted. To our knowledge, this is the first study to report on the perspectives of nAMD patients regarding the impact of the COVID-19 pandemic on their care. Three themes emerged from the analysis related to concerns about access to care, the effect of mitigating factors on care delivery, and the influence of patients’ individual circumstances. The most significant factor was the impact on access to care. Participants emphasised the importance ...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  3. Version published to 10.1101/2021.09.01.21262696v1 on medRxiv