Knowledge, Attitudes, and Practices of Patients with age-related macular degeneration (AMD) towards Anti-VEGF Treatment under One-stop Intravitreal Injection Model

Abstract

To evaluate the knowledge, attitudes, and practices (KAP) of patients with age-related macular degeneration (AMD) regarding anti-VEGF treatment within a one-stop intravitreal injection service model. A cross-sectional study was conducted from July 1, 2023, to January 31, 2024, at the One-stop Intravitreal Injection Center at Tianjin Medical University Eye Hospital. Data were collected using a specially designed KAP questionnaire. The study successfully enrolled 493 participants. Of these, 214 (43.4%) were aged between 70 and 79 years, and 226 (45.8%) had been diagnosed with AMD for 1–3 years. The median knowledge, attitude, and practice scores were 6.00 [3.00, 8.00] (possible range: 0–9), 42.00 [37.00, 48.00] (possible range: 11–55), and 23.00 [18.00, 27.00] (possible range: 6–30), respectively. Multivariate logistic regression for practice showed that knowledge score (OR = 1.329, P < 0.001), attitude score (OR = 1.150, P < 0.001), aged 60–69 years (OR = 0.398, P = 0.022) were independently associated with proactive practice. Mediating effect significance showed that knowledge directly affected attitude (β = 0.625), knowledge (β = 0.398) and attitude (β = 0.503) directly affected practice (P < 0.001). Meanwhile, knowledge also indirectly affected practice through attitude (β = 0.315, P < 0.001). Regarding the factors impacting their selection of anti-VEGF treatment, 63.5% of patients emphasized the crucial role of its effectiveness. Additionally, over 40% of patients considered both family circumstances and insurance coverage to be highly significant in their decision-making process. This study found that patients with AMD exhibit suboptimal knowledge yet hold positive attitudes and engage actively in practices concerning anti-VEGF treatment within a one-stop intravitreal injection service model. It is recommended that healthcare providers enhance educational interventions at intravitreal injection centers to boost patient knowledge, which is likely to further improve attitudes and proactive management practices among AMD patients.