The value of handholding during intravitreal injections.

Background: Repeated intravitreal injections (IVI) have become the therapeutic standard of care for multiple retinal conditions. Reducing discomfort and anxiety around IVIs is important to ensure ongoing patient compliance with therapy.

Aims: The study aimed to investigate if handholding during an IVI reduces patient anxiety, and to ascertain if their anxiety lessens following repeated therapy.

Methods: Patients attending for IVIs were asked preoperatively to plot their anxiety level using the visual analogue scale for anxiety (VASA) from 0-10. They were randomised into three groups: Hand-Held-Skin-to-Skin (HHS), Hand-Held-Skin-to-Glove (HHG) and Hand-not-Held (HNH) during IVI. Post-IVI, patients were asked to recall and plot their experienced level of anxiety at the time of their first injection (First Injection Anxiety, FIA) on the 0-10 visual analogue scale for anxiety. Both hand-held cohorts were also asked their preference for handholding for future injections.

Results: In total, 195 patients were surveyed: HHS, n = 67; HHG, n = 58 and HNH, n = 70. A total of 98% of respondents in both Hand-Held cohorts stated they found the intervention useful in reducing anxiety, with 97% saying they would like their hand held for subsequent IVIs. Patients' anxiety levels significantly reduced when their hand was held gloved or ungloved for IVIs (p = 0.007). IVI associated anxiety did not lessen with repeated therapy.

Conclusion: Patient stress levels are considerably reduced when their hand is held during IVI. Handholding is a useful intervention throughout the patient journey and not solely at the time of initiation of treatment.