Health and Economic Outcomes of Home Maintenance Allergen Immunotherapy in Select Patients with High Health Literacy during the COVID-19 Pandemic: A Cost-Effectiveness Analysis During Exceptional Times

Abstract

What is already known on this topic: Allergy/immunology clinical practices are not immune to natural disasters or global pandemics, which may force service reduction or abrupt changes in practice. What does this article add to our knowledge: Home allergen immunotherapy can be cost-effective in highly selected patients under pandemic shelter-in-place conditions provided home systemic reactions to immunotherapy rates remain stable; however, careful patient selection is critical. How does this study impact current management guidelines: This cost-effectiveness analysis demonstrates potential feasibility of allergen immunotherapy for appropriately screened patients. This may help inform decision making regarding how to provide this valuable allergy service in a current or future natural disaster or pandemic. BACKGROUND: Allergen immunotherapy (AIT) is safe and effective but is typically administered under strict clinic observation to mitigate the risk of a systemic reaction to immunotherapy (SRIT). However, in the setting of the global coronavirus disease 2019 pandemic, alternative care models should be explored. OBJECTIVE: To evaluate the cost-effectiveness of home immunotherapy self-administration (HITSA) in a highly

Economic evaluation of programs against COVID-19: A systematic review

“…Overall, 26 articles were included in this review. Most of these studies were from the US (n =9)( 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 ), followed by China (n = 4)( 4 , 23 , 24 , 25 ), the UK (n =2)( 26 , 27 ), Germany(n =2)( 28 , 29 ), India (n =2)( 30 , 31 ), Australia (n =1)( 32 ), Israel (n = 1)( 33 ), Morocco (n = 1)( 34 ), Ghana (n = 1)( 35 ), South Africa (n=1)( 36 ), Uganda (n=1)( 37 ), Thailand (n=1)( 38 ).…”

“…Eighteen studies assessed the programs against COVID-19 in the whole population( 4 , 14 , 16 , 20 , 21 , 22 , 23 , 24 , 26 , 28 , 30 , 32 , 33 , 34 , 35 , 36 , 37 ), four studies evaluated preventing programs among patients with COVID-19( 25 , 27 , 29 , 38 ), two studies focused on the healthcare workers (HCWs)( 17 , 18 ), one study on the academic students( 19 ) and last one on the patients with allergic rhinitis( 15 ).…”

“…Table 2 depicts fighting strategies for COVID-19. The three common strategies in most of the included studies were quarantine (n=10)( 4 , 22 , 23 , 24 , 30 , 31 , 33 , 34 , 35 , 36 ), screening and diagnostic tests (n=8)( 17 , 19 , 21 , 25 , 26 , 35 , 36 , 38 ), and social distancing (n=7)( 14 , 15 , 16 , 20 , 24 , 33 , 35 ) which they were evaluated for both target groups (such as high risk or forefront healthcare workers, and academic students) and the general population. A handful of studies evaluated PPE (n = 5)( 17 , 18 , 23 , 35 , 37 ) and isolation (n = 6)( 4 , 22 , 23 , 32 , 34 , 36 ).…”

“…The majority of included studies were from the social perspective (n =8)( 4 , 15 , 18 , 20 , 22 , 28 , 29 , 30 ). Six studies performed from the healthcare system perspective ( 4 , 15 , 21 , 25 , 27 , 36 ).…”

Compliance with COVID-19-Preventive Behaviours among Employees Returning to Work in the Post-Epidemic Period

“…Businesses should be aware of the employees' mental-health status before they return to work, and should provide psychological consultation services if necessary [23]. Further, false information on the Internet regarding COVID-19 can cause panic [28]; therefore, in the short term, it is necessary to strengthen the management of online information and support scienti c, in-depth, and continuous reporting by o cial media channels, which would serve to guide the direction of public opinion [24]; in the long term, public health literacy should be greatly improved [25].…”