Adherence to Subcutaneous Allergen Immunotherapy in Southeast Turkey: A Real-Life Study

Abstract

BackgroundSubcutaneous immunotherapy (SCIT) in allergic rhinitis (AR) and asthma is a very effective treatment, but adherence is still a serious problem. Studies addressing real-life adherence to SCIT are rare in the literature. The aim of this study was to evaluate the adherence to SCIT in AR and asthma.Material/MethodsThe medical records of patients prescribed SCIT for treatment of AR and/or asthma were evaluated. Patients who continued the SCIT treatment as prescribed were defined as adherent, patients who stopped the treatment before the recommended period were defined as nonpersistent, and those who never started the treatment were defined as primary poor adherence. Age, gender, residence, type of SCIT, comorbidities, occupation, income, and adverse reactions were evaluated between these groups.ResultsNinety-five patients prescribed SCIT for the treatment of AR and/or asthma formed our cohort (female/male: 51/44). The mean (SD) age and duration of SCIT were 32.2±10.0 (range, 17–63) years, 14.4±12.7 (1.0–58.5) months, respectively. Sixty-two (65.3%) patients were adherent, (28.4%) patients were nonpersistent, and 6 (6.3%) patients were primary poor adherent. Nineteen (21.4%) patients had local adverse reactions and one (1.1%) had anaphylaxis. There were no differences between groups for age, gender, residence, type of SCIT, comorbidities, income, or occupation. The most frequent reason of nonpersistence was the cost of treatment.ConclusionsOur study found that adherence to SCIT is low in a real-life setting in southeast Turkey, similar to most previous adherence studies.

Subcutaneous immunotherapy with aeroallergens Evaluation of adherence in real life

“…In literature, results regarding demographic and clinical data are also very variable. Tat also has not found differences in age or gender between the two groups [23]. Rhodes found a significant correlation between age and gender: non-adherent patients were younger than adherent and males were more frequently non-adherents than females [12].…”

“…Vaswani et al reported a rate of 40% of suspension due to SCIT costs, especially inadequate or nonexistent insurance coverage [25]. In his study, Tat also concluded that a main reason for SCIT suspension was the delayed reimbursement by health insurance [23]. [20].…”

“…Yang et al, described a discontinuation rate of 25.5% secondary to treatment inefficacy (second more frequent cause in their study) [19]. Tat described a withdrawal of 14.8% of patients secondary to lack of efficacy [23].…”

Adherence to Allergen Subcutaneous Immunotherapy is Increased by a Shortened Build‐Up Phase: A Retrospective Study

“…Adherence to AIT is usually reported as the percentage of patients who maintain the treatment over a defined period of time. Some adherence studies report data for short periods of observation (6-12 months) [13][14][15], but guidelines recommend that in order to be effective, AITmust be continued for at least three years [5,6]; therefore, we deemed important to investigate the three-year treatment persistence. In our survey, 63.4% of patients completed the requested third year of treatment.…”

“…We considered only patients who started the treatment at least 3 years before to allow a sufficient observation period. Since reimbursement issues are deemed important for patients' adherence [10,13,14], we also compared the adherence of 59 patients coming from 3 centers with full reimbursement with that of 86 patients from 3 centers with no reimbursement at all. While "adherence" to SCIT is not a standard defined concept, we evaluated the number of patients treated for at least two years, the number treated for at least three years, the number treated for more than three years, and the number of drop outs after one treatment year only.…”