Diabetic Macular Edema

Noncompliance, comorbidities remain major challenges in DME

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The challenges that patients with diabetic macular edema (DME) face are often multifactorial, said Randy Wong, MD and Eser Adiguzel, PhD, during a presentation at AAO 2021.

“We have to consider the disease burden, patient comorbidities, the huge issue of noncompliance, increased health care resource utilization…and the degree in which poor vision is the driving force for all of this,” said Dr Wong.

Lessening the burden of these challenges while maintaining sustained visual function in patients is a key obstacle in the management of DME, he said.

One issue providers face is that patient compliance with clinical visits is low for DME compared to some other diseases.

“A higher no-show for patients with DME may be attributed to higher monitoring burden due to multiple comorbidities associated with diabetes,” said Dr Wong.

One study found that patients with DME saw up to 7 medical experts during a 6-month visit, leading to higher healthcare resource utilization compared to non-DME patients with diabetes.

Another study found that when compared to non-DME patients with diabetes, patients with DME had more total healthcare visit days (16.9 vs 28.7) and outpatient visit days (16.1 vs 28).

Not complying with care may lead to a 10x higher rate of significant vision loss in DME, with one study showing 15.3% of patients who are noncompliant have ≥15 letter vision loss in their first year of treatment compared to 1.3% in patients who are compliant.

Wong R, et al. See What Matters in Diabetic Macular Edema (DME): The Multifactorial Challenges in DME. Industry Symposium Presented at: AAO 2021.

This Industry Symposium was presented by Novartis Pharmaceuticals Corporation.