Physician's recommendation and explanation is important in the initiation and maintenance of allergen immunotherapy

Abstract

BackgroundAllergen immunotherapy (AIT) is currently the only immune-modifying treatment for allergic disease. The clinical efficacy of AIT for the treatment of allergic rhinitis and bronchial asthma is well documented. However, many factors including inconvenience, cost, side effects, and adherence influence the initiation and persistence of AIT, and patients lack knowledge and have misconceptions about the treatment.ObjectiveWe evaluated the knowledge, attitude, and satisfaction of patients who received AIT.MethodsWe conducted a retrospective analysis of medical records of 167 patients who received AIT, and compared the clinical characteristics between conventional immunotherapy (CIT) and rush immunotherapy (RIT). Ninety-nine patients completed a questionnaire survey.ResultsOf the total 167 patients, 65.9% (n=110) were treated with CIT and 34.1% (n=57) with RIT. More than half of the patients (68.7%) initiated AIT according to their physician’s recommendation. Frequent hospital visits were the main barrier for persistence of AIT. RIT patients were younger and started AIT earlier than CIT patients. The majority (77%) of patients who received AIT were satisfied, with no significant difference between CIT and RIT groups. RIT and fewer allergens used in AIT were related with preference for AIT to pharmacotherapy. The longer duration of AIT was associated with higher treatment satisfaction.ConclusionA majority of patients initiated AIT by the physician’s recommendation and were satisfied with treatment regardless of CIT or RIT schedule. Adequate patient education and a strict patient–physician relationship in early AIT period could improve the effectiveness and compliance of AIT.

ARIA guideline 2019: treatment of allergic rhinitis in the German health system

“…The patient's view should always be considered in order to enable a tailor-made approach to shared decision making (SDM). In case studies on state of knowledge, awareness as a therapy option, expectations and satisfaction with the AIT, there were sometimes very different assessments between the physician's view and the patient's view [101,102]. Most studies complain about a lack of information on the patient side.…”

ARIA guideline 2019: treatment of allergic rhinitis in the German health system

“…The patient's view should always be considered to enable a tailor-made approach to shared decisionmaking (SDM). In case studies on state of knowledge, awareness as a therapy option, expectations and satisfaction with the AIT, there were sometimes very different assessments between the physician's view and the patient's view [102,103]. Most studies complain about a lack of information on the patient side.…”

ARIA 2019: Um Percurso Assistencial Integrado para a Rinite Alérgica em Portugal

“…maioria dos estudos reporta falta de informação dos doentes alérgicos, devendo ser envidados esforços no sentido de melhorar a comunicação, de forma a promover o aumento do conhecimento e da satisfação dos doentes. 99,100 A adesão à ITA é crucial para a sua eficácia. No entanto, a não adesão e a descontinuação prematura são comuns.…”