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Standardisation of Definitions

What definitions have been standardised?

The nAMD Barometer Leadership Coalition have developed and validated standardised definitions for (non-)adherence/persistence in the context of nAMD treatment, in order to:

 

  • Increase awareness of the role and importance of adherence and persistence among healthcare professionals and patients
  • Set uniform parameters for future research
  • Allow benchmarks to be established in order to measure the impact of future interventions

Full adherence

A patient is considered fully adherent to anti-VEGF therapy in nAMD if...

They attend every scheduled clinic appointment* (treatment or monitoring), and undergo every treatment or monitoring procedure advised by the treating physician
 

Persistence

A patient is considered persistent to anti-VEGF therapy in nAMD if...

They maintain treatment or monitoring as advised by the treating physician AND attended their most recent appointment†

Adherence

A patient is considered adherent to anti-VEGF therapy in nAMD if...

They miss no more than one treatment or monitoring visit* scheduled as advised by the treating physician over a period of 1 year
 

Non-persistence

A patient is considered non-persistent to anti-VEGF therapy in nAMD if...

  • They do not attend any treatment or monitoring visit for any reason for a period of 6 months‡
  • Follow-up appointments are not scheduled for any reason for a period of 6 months‡
     

Non-adherence

A patient is considered non-adherent to anti-VEGF therapy in nAMD if...

They miss two or more treatment or monitoring visits* scheduled as advised by the treating physician over a period of 1 year

Planned discontinuation or transfer of care

A patient is considered to have a planned discontinuation as defined by...

  • Lack of treatment response (treatment futility) judged by the treating physician
  • No disease activity requiring ongoing treatment judged by the treating physician

A patient is considered to have their care transferred if...

The ongoing management of the patient’s nAMD is transferred to another physician
 

*A visit is considered missed if the recommended appointment date is exceeded by more than 2 weeks for any reason.

†A patient is not required to be adherent in order to be persistent.

‡The first day of the 6-month period after the most recent appointment attended should serve as the onset of non-persistence date.