5.2 Combining treatment and counselling to improve patient outcomes – Julian Jackson

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Combining treatment and counselling to improve patient outcomes

Julian Jackson Director – Visionbridge

New research from Manchester Royal Eye Hospital has concluded that despite the extraordinary scientific achievements in diagnosing and treating serious eye diseases such as wet age related macular degeneration (wAMD), which have revolutionised our ability to reverse life-changing vision loss, high levels of anxiety and depression persist in patients. Therefore all health care professionals must ensure that patients can reap the full benefits of this cutting-edge science.

Manchester based researchers say that the study findings demonstrate the value of human interaction between clinician and patient in offering reassurance around the efficacy and safety associated with anti-VEGF injections and highlights how factors such as patients’ understanding and building strong relationships with healthcare professionals may help alleviate anxiety around receiving injections. Patients may benefit from additional assurances from clinical staff regarding success rates in halting disease progression with anti-VEGF therapy, how it can reduce the risk of becoming blind in the future and the low likelihood of serious problems occurring following the injections.

These research findings also point to the importance of considering specialised counselling for certain wAMD patients – indeed, literature has shown that tailored psychological and psychosocial interventions can be effective to reduce anxiety and depression in wAMD patients and contribute to their adjustment to illness and medical treatments. Although levels of depression reduce once anti-VEGF therapy is established, doctors should be vigilant to such symptoms and their potential to impair quality-of-life. It is believed that the use of standardised tools to screen wAMD patients for symptoms of anxiety and depression in the macular treatment unit could better help identify patients at risk. Further research and controlled trials will be needed to better understand anxiety and depression in wAMD patients and develop new intervention tools at patient and clinical level to reduce symptoms and improve quality-of-life.

This study was supported by the National Institute for Health Research (NIHR). It was also funded by a grant from Bayer, in order to support the ophthalmology community in transforming care and supporting people living with retinal conditions.

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