Table 4.
Risk Factors for Treatment or Visit Nonpersistence
| Risk Factors | Studies | Risk of NP (OR or Primary Reason for NP as % of Responses) | Effect of Risk Factor (Qualitative Studies) |
|---|---|---|---|
| Condition-Related Factors | |||
| Bilaterality | Obeid | −0.69 OR | |
| Ehlken | 3.704 OR | ||
| Rasmussen 2018 | 3.70 OR | ||
| Worse baseline VA | Oishi | 8.1 OR | Increased risk |
| Westborg | 1.42 OR | ||
| Polat | 0 vs. 22.6% | No difference | |
| McGrath | Increased risk | ||
| Bobykin | |||
| Boulanger | 42.5 vs. 51.0 letters | ||
| Ehlken 2018 | OR 2.37 | ||
| Worse baseline VA in fellow eye | Westborg | No difference | |
| Bobykin | Decreased risk | ||
| Worse final VA | Oishi | Increased risk | |
| Sii | Increased risk if in worse eye | ||
| Droege | Increased risk | ||
| Ehlken 2018 | Increased risk | ||
| No change in VA to treatment | Obeid | Increased risk | |
| Polat | Increased risk | ||
| Vaze | Increased risk | ||
| Nunes | Increased risk | ||
| Patient-Related Factors | |||
| Older age | Obeid | 1.58 OR 81–85 | |
| 2.29 OR 86–90 | |||
| 3.31 OR > 90 | |||
| Ehlken 2018 | OR 1.04 | ||
| Rasmussen 2018 | OR 1.05 | ||
| Westborg | No difference | ||
| Subhi | Increased age > 90 yrs | ||
| Rasmussen 2013 | Increased age | ||
| McGrath | No difference | ||
| Bobykin | Increased > 80 yrs | ||
| Wintergerst | Increased | ||
| Husler | 13.0% | ||
| Boulanger | 82.0 vs. 76.6 yrs | ||
| Non-White ethnicity | Obeid | 1.47 OR African American | |
| 2.63 OR Asian American | |||
| 3.07 OR other ethnicity | |||
| Systemic illness | Westborg | 1.27 OR | |
| Oishi | Increased risk | ||
| Droege | 16.7% | ||
| Rasmussen 2013 | 41.5% | ||
| McGrath | 0.48 OR | ||
| Kruger Falk | 5.6% | ||
| Vaze | 42.3% | ||
| Nunes | 15.8% | ||
| Heimes | 26% | ||
| Wintergast | 25% | ||
| Huser | 8.9% | ||
| Ocular comorbidities | |||
| Fear of injections | Polat | 29.6% | |
| Droege | 5.3% | ||
| Kruger Falk | 2.8% | ||
| Vaze | 11.5% | ||
| Wintergast | 25% | ||
| Huser | 8.9% | ||
| Perception injections not helpful or not needed | Polat | 21.6% | |
| Rasmussen 2013 | Increased risk | ||
| McGrath | 10.4% | ||
| Kruger Falk | 8.3% | ||
| Vaze | 23.1% | ||
| Nunes | 42.1% | ||
| Wintergast | 11% | ||
| Huser | 21.7% | ||
| Loss of motivation | Droege | 38% | |
| Heimes | 5% | ||
| Therapy-Related Factors | |||
| Treatment regimen | Hanemoto | Decreased burden for T&E vs. PRN | |
| Droege | Decreased burden for PRN vs. monthly | ||
| Same day injection | Krivosic | Decreased risk | |
| Anti-VEGF drug type | Subhi | No difference | |
| Westborg | 1.45 OR RBZ vs. AFL | ||
| Health Systems and Healthcare Team Factors | |||
| Lack of information | Nunes | 26.3% | |
| Huser | 4.3% | ||
| Varano | Increased risk | ||
| Did not like or trust physician | Kruger Falk | 2.8% | |
| Huser | 8.7% | ||
| Tertiary center | Westborg | 1.30 OR | |
| Rasmussen 2018 | 0.33 OR | ||
| Dissatisfaction with treatment center | Polat | 17.6% | |
| Longer distance from home to treatment center | Polat | R value = −0.227 | |
| Obeid | 1.33 OR 21–30 miles | ||
| 1.55 OR > 30 miles | |||
| Boyle | Increased risk > 50 km | ||
| McGrath | 2.48 OR | ||
| Boulanger | Median distance 18 vs. 40 km | ||
| Follow-up burden | Polat | 16% | |
| Boyle | Increased with shorter intervals | ||
| Subhi | Increased risk | ||
| Droege | 18.9% | ||
| Rasmussen | Increased risk | ||
| Kruger Falk | 8.3% | ||
| Vaze | 7.7% | ||
| Huser | 13.0% | ||
| Fixed appointments | Rasmussen 2018 | 0.44 OR | |
| Difficulties with appointments | Nunes | 10.5% | |
| Social/Economic Factors | |||
| Lower socioeconomic status | Obeid | 1.52 OR | |
| Social isolation or lack of carer | Polat | 16% | |
| Oishi | Increased risk | ||
| Droege | 61.5% | ||
| Wintergerst | Increased risk | ||
| Huser | 8.9% | ||
| Lack of insurance status | McGrath | No difference | |
| Heimes | 3% | ||
| Wintergast | 5% | ||
| Financial burden | Polat | 20.8% | |
| Oishi | Increased risk | ||
| Boyle | Increased risk (indirect costs) | ||
| Droege | 34.8% | ||
| McGrath | 8.1% | ||
| Vaze | 7.7% | ||
| Wintergast | 10% | ||
| Huser | 13% | ||
| Holz | 2% | ||
| Spooner | Increased burden (direct and indirect costs) | ||
| Lack of transport | Droege | 46.3% | |
| Rasmussen | Increased risk | ||
| Vaze | 7.7% | ||
| Nunes | 5.3% | ||
| Heimes | 38% | ||
| Wintergast | 27% |
AFL = aflibercept; NP = nonpersistence; OR = odds ratio; PRN = pro re nata; RBZ = ranibizumab; T&E = treat-and-extend; VA = visual acuity; VEGF = vascular endothelial growth factor.