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BMC Health Services Research

, 5:34

First Online: 10 May 2005Received: 12 January 2005Accepted: 10 May 2005DOI: 10.1186-1472-6963-5-34

Cite this article as: Foy, R.C., Foot, B., Francis, J. et al. BMC Health Serv Res 2005 5: 34. doi:10.1186-1472-6963-5-34


BackgroundThere has been debate about the cost-effectiveness of photodynamic therapy PDT, a treatment for neovascular age-related macular degeneration. We have been monitoring trends for the provision of PDT in the UK National Health Service. The fourth annual -tracker- survey took place as definitive National Institute for Clinical Excellence NICE guidance was issued. We assessed trends in PDT provision up to the point of release of the NICE guidance and identified likely sources of pressure on ophthalmologists to provide PDT.

MethodsNational postal questionnaire survey of clinicians with potential responsibility for PDT provision. The survey explored reported local provision, beliefs about the effectiveness of PDT and what sources of opinion might influence attitudes towards providing PDT.

ResultsThe response rate was 73% 111-150. Almost half of the surveyed ophthalmology units routinely provided PDT, as part of a trend of steady growth in provision. The proportion of respondents who believed that further proof of effectiveness was required has also declined despite the absence of any new substantial evidence. Attitudes towards providing PDT were positive, on average, and were more strongly associated with perceived social pressure from local colleagues than from other sources. Local colleagues were seen as being most approving of PDT.

ConclusionThose responsible for implementing the NICE guidance need to address ophthalmologists- beliefs about the evidence of effectiveness for PDT and draw upon supportive local individuals or networks to enhance the credibility of the guidance.

Electronic supplementary materialThe online version of this article doi:10.1186-1472-6963-5-34 contains supplementary material, which is available to authorized users.

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Autor: Robbie C Foy - Barny Foot - Jill Francis - Usha Chakravarthy - Richard PL Wormald


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