Waiting room educational media effect on preinjection anxiety for initial intravitreal injections

OBJECTIVE: To ascertain the effectiveness of an educational web page in reducing anxiety associated with initial intravitreal anti-vascular endothelial growth factor injections. DESIGN: Single-centred, observation-enriched, randomized controlled trial. PARTICIPANTS: Ninety-six patients receiving intravitreal injections at the Hamilton Regional Eye Institute. METHODS: Patients aged 18 years or older scheduled to receive their first intravitreal injection were randomized to either view an educational web page pertaining to the injection procedure or wait 30 minutes. Both groups then completed the State-Trait Anxiety Inventory (STAI). A third cohort of patients who previously had intravitreal injections waited 30 minutes before completing the STAI. The difference between STAI anxiety scores across cohorts 1 through 3 was assessed using analysis of variance and independent t tests where applicable. RESULTS: Ninety-six patients completed the STAI questionnaires, of which 55 (57.3%) were female and 86 (89.6%) were Caucasian. The mean age of participants was 68.5 ± 14.2 years, 72.7 ± 12.9 years, and 70.4 ± 11.7 years for control, intervention, and treatment-experienced cohorts, respectively. The mean STAI score was 40.3 ± 12.0 for the control cohort, 39.3 ± 11.1 for the intervention cohort, and 30.2 ± 9.9 for the treatment-experienced cohort. No significant difference in STAI scores was observed between intervention and control cohorts (p = 0.716). The effect size between treatment-naïve and treatment-experienced cohorts was high, ranging from 0.862 and 0.919, and the mean difference in STAI scores was significant. CONCLUSIONS: Compared to treatment-experienced patients, treatment-naïve patients are more anxious. Electronic educational information about the intravitreal injection process may be ineffective at reducing procedure-induced anxiety.