Strategies for Improving Patient Comfort During Intravitreal Injections: Results from a Survey-Based Study

Jessica Gomez, Dara Koozekanani, Alex Z. Feng, Mitchell Holt, Paul Drayna, Melissa R. Mackley, Erik van Kuijk, Robert M. Beardsley, Richard H. Johnston, Joseph M. Terry, Sandra Rocio Montezuma

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Introduction: Many ocular diseases require intravitreal injections of pharmacological agents. Optimizing patients’ experiences during injections is important to ensure compliance and maintenance of quality of life. The objective of this study was to identify strategies to help alleviate discomfort during intravitreal injections. Methods: A cross-sectional study surveying 128 patients during clinic visits between 2014 and 2015 in two outpatient Retina Clinics (one academic and one private). Patients receiving an intravitreal injection(s) for any retinal disorder were given a questionnaire with 10-yes/no responses for various potential strategies. Responses were stratified by sex, age (<30 years, 30–60 years, and >60 years) and total number of prior injections (0–9 injections, 10–20 injections and >20 injections). Results: A total of 128 patients were surveyed: 59 males, 41 females and 28 with no sex specified. Our results identified four favorable strategies as those receiving more than 50% “yes” votes. These included the presence of technician/staff during the procedure, the use of a neck pillow, a verbal warning before the injection and performing injections in both eyes on the same day. Other specific strategies were identified for females, younger patients and those with greatest experience. These included: females preferred having their hand held during injections (P = 0.001) and using a stress ball (P = 0.000) when compared to males. Stratifying by age, patients 30–60 years old preferred having their hand held (P = 0.008) and background music (P = 0.007). Stratifying by prior injections, patients with >20 prior injections preferred having their hand held (P = 0.001), using a stress ball (P = 0.021) and, if necessary, having bilateral injections performed the same day to improve comfort (P = 0.037). Conclusions: Having an extra staff member present during the injection, having a neck pillow, having a verbal warning prior to injection and having both eyes injected on the same day were indicated as favorable strategies by over half of those surveyed. Further, specific strategies were identified for females, younger patients (30–60 years old) and those with greatest experience (>20 injections).

Original languageEnglish (US)
Pages (from-to)183-190
Number of pages8
JournalOphthalmology and Therapy
Volume5
Issue number2
DOIs
StatePublished - Dec 1 2016

Fingerprint

Intravitreal Injections
Injections
Hand
Patient Comfort
Surveys and Questionnaires
Neck
Eye Diseases
Music
Ambulatory Care
Ambulatory Care Facilities
Compliance
Retina

Keywords

  • Comfort
  • Drug delivery
  • Intravitreal injection
  • Patient
  • Quality improvement
  • Retinal disease

Cite this

Strategies for Improving Patient Comfort During Intravitreal Injections : Results from a Survey-Based Study. / Gomez, Jessica; Koozekanani, Dara; Feng, Alex Z.; Holt, Mitchell; Drayna, Paul; Mackley, Melissa R.; van Kuijk, Erik; Beardsley, Robert M.; Johnston, Richard H.; Terry, Joseph M.; Montezuma, Sandra Rocio.

In: Ophthalmology and Therapy, Vol. 5, No. 2, 01.12.2016, p. 183-190.

Research output: Contribution to journalArticle

Gomez, Jessica ; Koozekanani, Dara ; Feng, Alex Z. ; Holt, Mitchell ; Drayna, Paul ; Mackley, Melissa R. ; van Kuijk, Erik ; Beardsley, Robert M. ; Johnston, Richard H. ; Terry, Joseph M. ; Montezuma, Sandra Rocio. / Strategies for Improving Patient Comfort During Intravitreal Injections : Results from a Survey-Based Study. In: Ophthalmology and Therapy. 2016 ; Vol. 5, No. 2. pp. 183-190.
@article{fbaf6a93705142f7b1b354afb38e6f0e,
title = "Strategies for Improving Patient Comfort During Intravitreal Injections: Results from a Survey-Based Study",
abstract = "Introduction: Many ocular diseases require intravitreal injections of pharmacological agents. Optimizing patients’ experiences during injections is important to ensure compliance and maintenance of quality of life. The objective of this study was to identify strategies to help alleviate discomfort during intravitreal injections. Methods: A cross-sectional study surveying 128 patients during clinic visits between 2014 and 2015 in two outpatient Retina Clinics (one academic and one private). Patients receiving an intravitreal injection(s) for any retinal disorder were given a questionnaire with 10-yes/no responses for various potential strategies. Responses were stratified by sex, age (<30 years, 30–60 years, and >60 years) and total number of prior injections (0–9 injections, 10–20 injections and >20 injections). Results: A total of 128 patients were surveyed: 59 males, 41 females and 28 with no sex specified. Our results identified four favorable strategies as those receiving more than 50{\%} “yes” votes. These included the presence of technician/staff during the procedure, the use of a neck pillow, a verbal warning before the injection and performing injections in both eyes on the same day. Other specific strategies were identified for females, younger patients and those with greatest experience. These included: females preferred having their hand held during injections (P = 0.001) and using a stress ball (P = 0.000) when compared to males. Stratifying by age, patients 30–60 years old preferred having their hand held (P = 0.008) and background music (P = 0.007). Stratifying by prior injections, patients with >20 prior injections preferred having their hand held (P = 0.001), using a stress ball (P = 0.021) and, if necessary, having bilateral injections performed the same day to improve comfort (P = 0.037). Conclusions: Having an extra staff member present during the injection, having a neck pillow, having a verbal warning prior to injection and having both eyes injected on the same day were indicated as favorable strategies by over half of those surveyed. Further, specific strategies were identified for females, younger patients (30–60 years old) and those with greatest experience (>20 injections).",
keywords = "Comfort, Drug delivery, Intravitreal injection, Patient, Quality improvement, Retinal disease",
author = "Jessica Gomez and Dara Koozekanani and Feng, {Alex Z.} and Mitchell Holt and Paul Drayna and Mackley, {Melissa R.} and {van Kuijk}, Erik and Beardsley, {Robert M.} and Johnston, {Richard H.} and Terry, {Joseph M.} and Montezuma, {Sandra Rocio}",
year = "2016",
month = "12",
day = "1",
doi = "10.1007/s40123-016-0058-2",
language = "English (US)",
volume = "5",
pages = "183--190",
journal = "Ophthalmology and Therapy",
issn = "2193-8245",
publisher = "Springer London",
number = "2",

}

TY - JOUR

T1 - Strategies for Improving Patient Comfort During Intravitreal Injections

T2 - Results from a Survey-Based Study

AU - Gomez, Jessica

AU - Koozekanani, Dara

AU - Feng, Alex Z.

AU - Holt, Mitchell

AU - Drayna, Paul

AU - Mackley, Melissa R.

AU - van Kuijk, Erik

AU - Beardsley, Robert M.

AU - Johnston, Richard H.

AU - Terry, Joseph M.

AU - Montezuma, Sandra Rocio

PY - 2016/12/1

Y1 - 2016/12/1

N2 - Introduction: Many ocular diseases require intravitreal injections of pharmacological agents. Optimizing patients’ experiences during injections is important to ensure compliance and maintenance of quality of life. The objective of this study was to identify strategies to help alleviate discomfort during intravitreal injections. Methods: A cross-sectional study surveying 128 patients during clinic visits between 2014 and 2015 in two outpatient Retina Clinics (one academic and one private). Patients receiving an intravitreal injection(s) for any retinal disorder were given a questionnaire with 10-yes/no responses for various potential strategies. Responses were stratified by sex, age (<30 years, 30–60 years, and >60 years) and total number of prior injections (0–9 injections, 10–20 injections and >20 injections). Results: A total of 128 patients were surveyed: 59 males, 41 females and 28 with no sex specified. Our results identified four favorable strategies as those receiving more than 50% “yes” votes. These included the presence of technician/staff during the procedure, the use of a neck pillow, a verbal warning before the injection and performing injections in both eyes on the same day. Other specific strategies were identified for females, younger patients and those with greatest experience. These included: females preferred having their hand held during injections (P = 0.001) and using a stress ball (P = 0.000) when compared to males. Stratifying by age, patients 30–60 years old preferred having their hand held (P = 0.008) and background music (P = 0.007). Stratifying by prior injections, patients with >20 prior injections preferred having their hand held (P = 0.001), using a stress ball (P = 0.021) and, if necessary, having bilateral injections performed the same day to improve comfort (P = 0.037). Conclusions: Having an extra staff member present during the injection, having a neck pillow, having a verbal warning prior to injection and having both eyes injected on the same day were indicated as favorable strategies by over half of those surveyed. Further, specific strategies were identified for females, younger patients (30–60 years old) and those with greatest experience (>20 injections).

AB - Introduction: Many ocular diseases require intravitreal injections of pharmacological agents. Optimizing patients’ experiences during injections is important to ensure compliance and maintenance of quality of life. The objective of this study was to identify strategies to help alleviate discomfort during intravitreal injections. Methods: A cross-sectional study surveying 128 patients during clinic visits between 2014 and 2015 in two outpatient Retina Clinics (one academic and one private). Patients receiving an intravitreal injection(s) for any retinal disorder were given a questionnaire with 10-yes/no responses for various potential strategies. Responses were stratified by sex, age (<30 years, 30–60 years, and >60 years) and total number of prior injections (0–9 injections, 10–20 injections and >20 injections). Results: A total of 128 patients were surveyed: 59 males, 41 females and 28 with no sex specified. Our results identified four favorable strategies as those receiving more than 50% “yes” votes. These included the presence of technician/staff during the procedure, the use of a neck pillow, a verbal warning before the injection and performing injections in both eyes on the same day. Other specific strategies were identified for females, younger patients and those with greatest experience. These included: females preferred having their hand held during injections (P = 0.001) and using a stress ball (P = 0.000) when compared to males. Stratifying by age, patients 30–60 years old preferred having their hand held (P = 0.008) and background music (P = 0.007). Stratifying by prior injections, patients with >20 prior injections preferred having their hand held (P = 0.001), using a stress ball (P = 0.021) and, if necessary, having bilateral injections performed the same day to improve comfort (P = 0.037). Conclusions: Having an extra staff member present during the injection, having a neck pillow, having a verbal warning prior to injection and having both eyes injected on the same day were indicated as favorable strategies by over half of those surveyed. Further, specific strategies were identified for females, younger patients (30–60 years old) and those with greatest experience (>20 injections).

KW - Comfort

KW - Drug delivery

KW - Intravitreal injection

KW - Patient

KW - Quality improvement

KW - Retinal disease

UR - http://www.scopus.com/inward/record.url?scp=85048151809&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85048151809&partnerID=8YFLogxK

U2 - 10.1007/s40123-016-0058-2

DO - 10.1007/s40123-016-0058-2

M3 - Article

AN - SCOPUS:85048151809

VL - 5

SP - 183

EP - 190

JO - Ophthalmology and Therapy

JF - Ophthalmology and Therapy

SN - 2193-8245

IS - 2

ER -