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.
