The Association of Retinal Disease with Vision Impairment and Functional Status in Medicare Patients
**Background:** The association of neovascular age-related macular degeneration (nAMD), diabetic macular edema (DME), and retinal vein occlusion (RVO) with functional status in the general Medicare population are not well established. **Objectives:** This study examined patient-reported survey data...
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| Format: | Article |
| Language: | English |
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Columbia Data Analytics, LLC
2024-03-01
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| Series: | Journal of Health Economics and Outcomes Research |
| Online Access: | https://doi.org/10.36469/001c.93022 |
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| author | Vincent Garmo Xiaohui Zhao Carmen D. Ng Aimee Near Tania Banerji Keiko Wada Gary Oderda Diana Brixner Joseph Biskupiak Ferhina S. Ali Archad M. Khanani Alicia Menezes Ibrahim M. Abbass |
| author_facet | Vincent Garmo Xiaohui Zhao Carmen D. Ng Aimee Near Tania Banerji Keiko Wada Gary Oderda Diana Brixner Joseph Biskupiak Ferhina S. Ali Archad M. Khanani Alicia Menezes Ibrahim M. Abbass |
| author_sort | Vincent Garmo |
| collection | DOAJ |
| description | **Background:** The association of neovascular age-related macular degeneration (nAMD), diabetic macular edema (DME), and retinal vein occlusion (RVO) with functional status in the general Medicare population are not well established.
**Objectives:** This study examined patient-reported survey data linked with Medicare claims to describe the burden of these vision-threatening retinal diseases (VTRDs) among Medicare beneficiaries.
**Methods:** Medicare Current Beneficiary Survey data linked with Medicare Fee-for-Service claims data from 2006 to 2018 were used in a nationally representative retrospective pooled cross-sectional population-based comparison study. Outcomes between community-dwelling beneficiaries with nAMD (n = 1228), DME (n = 101), or RVO (n = 251) were compared with community-dwelling beneficiaries without any VTRDs (n = 104 088), controlling for baseline demographic and clinical differences. Beneficiaries with a diagnosis of nAMD, DME, or RVO during the data year were included; those with other VTRDs were excluded. Outcomes included vision function and loss, overall functioning as assessed by difficulties with activities of daily living (ADLs) and instrumental ADLs (iADLs), anxiety/depression, falls, and fractures.
Results: In patient cohorts with nAMD, DME, and RVO, approximately one-third (34.2%-38.3%) reported “a little trouble seeing” (vs 28.3% for controls), and 26%, 17%, and 9%, respectively, reported “a lot of trouble seeing/blindness” (vs 5% of controls). Difficulty walking and doing heavy housework were the most reported ADLs and iADLs, respectively. Compared with those without VTRDs, beneficiaries with nAMD had higher odds of diagnosed vision loss (odds ratio \[OR\], 5.39; 95% confidence interval, 4.06-7.16; P < .001) and difficulties with iADLs (odds ratio, 1.41; 95% confidence interval, 1.11-1.80; P = .005); no differences were observed for DME or RVO vs control. After adjusting for age, sex, race/ethnicity, poverty status, comorbidities, and other relevant covariates, nAMD, DME, and RVO were not significantly associated with anxiety/depression, falls, or fractures.
**Discussion:** Patients with nAMD or DME were more likely to report severe visual impairment than those without VTRDs, although only those with nAMD were more likely to be diagnosed with vision loss.
**Conclusions:** Patients with nAMD continue to experience more vision impairment and worse functional status compared with a similar population of Medicare beneficiaries despite availability of therapies like antivascular endothelial growth factor to treat retinal disease. |
| format | Article |
| id | doaj-art-8201ae55545b4009b4cb747fcd449ac8 |
| institution | Kabale University |
| issn | 2327-2236 |
| language | English |
| publishDate | 2024-03-01 |
| publisher | Columbia Data Analytics, LLC |
| record_format | Article |
| series | Journal of Health Economics and Outcomes Research |
| spelling | doaj-art-8201ae55545b4009b4cb747fcd449ac82025-02-10T16:12:47ZengColumbia Data Analytics, LLCJournal of Health Economics and Outcomes Research2327-22362024-03-01111The Association of Retinal Disease with Vision Impairment and Functional Status in Medicare PatientsVincent GarmoXiaohui ZhaoCarmen D. NgAimee NearTania BanerjiKeiko WadaGary OderdaDiana BrixnerJoseph BiskupiakFerhina S. AliArchad M. KhananiAlicia MenezesIbrahim M. Abbass**Background:** The association of neovascular age-related macular degeneration (nAMD), diabetic macular edema (DME), and retinal vein occlusion (RVO) with functional status in the general Medicare population are not well established. **Objectives:** This study examined patient-reported survey data linked with Medicare claims to describe the burden of these vision-threatening retinal diseases (VTRDs) among Medicare beneficiaries. **Methods:** Medicare Current Beneficiary Survey data linked with Medicare Fee-for-Service claims data from 2006 to 2018 were used in a nationally representative retrospective pooled cross-sectional population-based comparison study. Outcomes between community-dwelling beneficiaries with nAMD (n = 1228), DME (n = 101), or RVO (n = 251) were compared with community-dwelling beneficiaries without any VTRDs (n = 104 088), controlling for baseline demographic and clinical differences. Beneficiaries with a diagnosis of nAMD, DME, or RVO during the data year were included; those with other VTRDs were excluded. Outcomes included vision function and loss, overall functioning as assessed by difficulties with activities of daily living (ADLs) and instrumental ADLs (iADLs), anxiety/depression, falls, and fractures. Results: In patient cohorts with nAMD, DME, and RVO, approximately one-third (34.2%-38.3%) reported “a little trouble seeing” (vs 28.3% for controls), and 26%, 17%, and 9%, respectively, reported “a lot of trouble seeing/blindness” (vs 5% of controls). Difficulty walking and doing heavy housework were the most reported ADLs and iADLs, respectively. Compared with those without VTRDs, beneficiaries with nAMD had higher odds of diagnosed vision loss (odds ratio \[OR\], 5.39; 95% confidence interval, 4.06-7.16; P < .001) and difficulties with iADLs (odds ratio, 1.41; 95% confidence interval, 1.11-1.80; P = .005); no differences were observed for DME or RVO vs control. After adjusting for age, sex, race/ethnicity, poverty status, comorbidities, and other relevant covariates, nAMD, DME, and RVO were not significantly associated with anxiety/depression, falls, or fractures. **Discussion:** Patients with nAMD or DME were more likely to report severe visual impairment than those without VTRDs, although only those with nAMD were more likely to be diagnosed with vision loss. **Conclusions:** Patients with nAMD continue to experience more vision impairment and worse functional status compared with a similar population of Medicare beneficiaries despite availability of therapies like antivascular endothelial growth factor to treat retinal disease.https://doi.org/10.36469/001c.93022 |
| spellingShingle | Vincent Garmo Xiaohui Zhao Carmen D. Ng Aimee Near Tania Banerji Keiko Wada Gary Oderda Diana Brixner Joseph Biskupiak Ferhina S. Ali Archad M. Khanani Alicia Menezes Ibrahim M. Abbass The Association of Retinal Disease with Vision Impairment and Functional Status in Medicare Patients Journal of Health Economics and Outcomes Research |
| title | The Association of Retinal Disease with Vision Impairment and Functional Status in Medicare Patients |
| title_full | The Association of Retinal Disease with Vision Impairment and Functional Status in Medicare Patients |
| title_fullStr | The Association of Retinal Disease with Vision Impairment and Functional Status in Medicare Patients |
| title_full_unstemmed | The Association of Retinal Disease with Vision Impairment and Functional Status in Medicare Patients |
| title_short | The Association of Retinal Disease with Vision Impairment and Functional Status in Medicare Patients |
| title_sort | association of retinal disease with vision impairment and functional status in medicare patients |
| url | https://doi.org/10.36469/001c.93022 |
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