Geographic atrophy (GA) is a chronic eye disease that leads to vision loss. People with GA will experience difficulties performing everyday tasks such as reading and driving. Over time, as vision loss gets worse more tasks will become difficult for people with GA, and the risk of events such as falls and trips or burns can increase. Vision loss and subsequent changes to everyday living can adversely affect the mental health and wellbeing of people with GA.
There is limited research on the occurrence of falls and trips, burns, or mental health complications in people with GA, or the healthcare burden due to these events. We will use anonymous data from GP and hospital records from England to describe these events and their healthcare cost in people with GA compared to people who do not have GA.
The results of our study will increase the understanding of the clinical and economic consequences experienced due to GA and should help guide methods to support patients and prevent complications people with GA might experience.
Geographic atrophy (GA) is an advanced stage of dry age-related macular degeneration (dAMD). While vision loss occurs progressively as dAMD advances, GA is characterised by irreversible central vision loss. As vision loss progresses, individuals with GA experience difficulties in daily activities which can be mentally and emotionally challenging. Vision loss increases the risk of accidental injury such as burns and scalds, or trips and falls which can lead to fractures.
In this retrospective cohort study, we will use linked data from the Clinical Practice Research Datalink, Hospital Episode Statistics, and Office for National Statistics death registrations, to quantify the healthcare resource use (HCRU) and associated cost of GA. We will estimate the all-cause primary and secondary care activity and describe annualised results, using descriptive statistics including means and medians, among patients with GA and matched controls. Similarly, we will describe activity specific to falls or fractures, burns or scalds, and mental health complications. We will then use multivariable generalised linear models with gamma family and log link to compare the annualised all-cause, falls or fractures, burns or scalds, and mental health complications costs in patients with GA to matched controls. To contextualise our findings, we will also describe the incidence of falls or fractures, burns or scalds, and mental health complications among patients with GA and matched controls, and use multivariable Poisson regression to estimate incidence rate ratios for the events. Finally, we will use multivariable Cox proportional hazard regression to compare death in patients with GA to matched controls.
The results generated from this study will quantify the effect GA has on falls or fractures, burns or scalds, and mental health complications as well as the associated healthcare burden, thereby highlighting where support and prevention strategies for GA patients may be best focused.
Annualised length of stay; Annualised number of hospitalisations; Annualised number of outpatient appointments; Annualised number of A&E attendances; Annualised number of primary care consultations; Annualised cost of hospitalisations; Annualised cost of outpatient appointments; Annualised cost of A&E attendances; Annualised cost of primary care consultations; Number, proportion and incidence of falls or fractures; Number, proportion and incidence of burns or scalds; Number, proportion and incidence of mental health complications; Annualised number of mental health-related primary care referrals; Annualised cost of mental health-related primary care referrals (number and cost); Number and proportion of patients discharged to residential or nursing home; Number, proportion and incidence of deaths;
Jennifer Davidson - Chief Investigator - Health iQ Ltd ( UK ) t/a CorEvitas
Caitlin Winton - Corresponding Applicant - Health iQ Ltd ( UK ) t/a CorEvitas
Caoimhe Rice - Collaborator - Health iQ Ltd ( UK ) t/a CorEvitas
Hannah Brewer - Collaborator - Health iQ Ltd ( UK ) t/a CorEvitas
James Baird - Collaborator - Health iQ Ltd ( UK ) t/a CorEvitas
Mico Hamlyn - Collaborator - Health iQ Ltd ( UK ) t/a CorEvitas
Sara Carvalho - Collaborator - Health iQ Ltd ( UK ) t/a CorEvitas
Hannah Brewer - Collaborator - Health iQ Ltd ( UK ) t/a CorEvitas
James Baird - Collaborator - Health iQ Ltd ( UK ) t/a CorEvitas
HES Accident and Emergency;HES Admitted Patient Care;HES Outpatient;ONS Death Registration Data;Patient Level Index of Multiple Deprivation