Introduction: Treatment burden significantly impacts patient adherence and quality of life when it comes to chronic conditions requiring frequent medical interventions. Intravitreal injections are administered to over 20 million patients globally annually, yet the associated treatment burden remains poorly quantified in Irish healthcare settings. This study aimed to assess treatment burden and identify key predictors among patients receiving intravitreal injections for retinal conditions at a tertiary eye center in Ireland.

Materials & Methods A cross-sectional questionnaire-based study was conducted using a modified Treatment Burden Questionnaire (TBQ) alongside demographic and qualitative assessments. Eligible participants included adults undergoing intravitreal injection treatment, excluding first-time attendees and those with insufficient English proficiency. The TBQ assessed treatment demands, medical follow-up, and financial burdens on a 0-10 Likert scale (total range 0-130). Supplementary questions addressed travel logistics, costs, and service perceptions. Correlation analysis and multiple linear regression identified predictors of treatment burden.

Results We enrolled 73 participants (52.1% male, mean age 74.2 years). Most participants (74%) required transport assistance, with mean travel times of 54.9 minutes and average costs of €22.08 per appointment. The mean TBQ score was 34.1 (SD 21.71), with 13.7% experiencing high treatment burden (≥59). Parking difficulties affected 89.8% of respondents. Correlation analysis identified commute duration (r=0.400, p<0.001) and difficulty arranging transport (r=0.465, p<0.001) as the strongest predictors of treatment burden. Age, gender, and costs showed no significant associations.

Conclusions We demonstrate that transportation logistics are the primary drivers of treatment burden in Irish patients receiving intravitreal therapy, rather than demographic or financial factors. These findings highlight the urgent need for satellite treatment centers and enhanced transport support along with possible extended dosing intervals and bilateral same day injections to reduce patient burden and improve treatment sustainability.

Intravitreal therapy, Burden of treatment, Age related macular degeneration, Diabetic macular oedema, Carbon footprint, Patient experience, Bevacizumab, Faricimab, Aflibercept, Treatment-related burnout