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[Switching the Treatment Regime from PRN (pro re nata, as needed) to T&E (Treat and Extend) for Intravitreal Therapy with Anti-VEGF Agents in Private Practice or Small Institutions].

Abstract：

:In everyday practice, intravitreal therapy in an "as needed" regimen (pro re nata, PRN) is less predictable and requires more visits (monitoring and injections taken together) with poorer functional results than with the treat and extend (T&E) regimen. Current literature supports the benefit of a switch. However, practical advice is still missing. This article provides "best practice" recommendations for private practice or smaller institutions for the change from PRN to T&E. The requirements are organisational adjustments, staff training, definition of the scenario triggering the switch (A - functional or anatomical deterioration; B - general switch at a predefined date), counselling of the patients, defining benchmarks for the follow-up of the switch and preparing for higher capacity utilisation during the transition (shorter treatment intervals during the switching phase). Guidance is provided for each phase (a, preparation; b, transition; and c, follow-up). :Im klinischen Alltag ist das Pro-re-nata-Regime (PRN) weniger gut planbar, bedarf häufigerer Termine und bringt weniger gute klinische Ergebnisse als Treat and Extend (T&E). Aktuelle Literatur spricht für den Nutzen eines Regimewechsels, jedoch fehlt eine praktische Richtlinie. „Best-Practice“-Empfehlungen für die Praxis oder kleinere Institutionen werden hier für alle 3 Phasen angeboten: a) Vorbereitungsphase mit Ändern der Terminorganisation, Schulung von Personal und Patienten, Definieren von Qualitätsparametern, Definieren des Umstellungsschemas (Umstellung für alle zu Termin X oder individuell bei Verschlechterung); b) Umstellungsphase (erhöhter Ressourcenbedarf durch zunächst verkürzte Behandlungsintervalle) und c) Folgephase (Qualitätskontrolle).

journal_name

Klin Monbl Augenheilkd

journal_title

Klinische Monatsblatter fur Augenheilkunde

authors

Imesch P,Sarra GM

doi

10.1055/s-0042-118184

subject

Has Abstract

pub_date

2018-01-01 00:00:00

pages

39-46

issue

eissn

0023-2165

issn

1439-3999

journal_volume

235

pub_type

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[Switching the Treatment Regime from PRN (pro re nata, as needed) to T&E (Treat and Extend) for Intravitreal Therapy with Anti-VEGF Agents in Private Practice or Small Institutions].