Patient dropouts from sublingual allergen specific immunotherapy with house dust mites. Solving a problem.
- Authors: Trusova O.V.1, Kamaev A.V.1, Makarova I.V.1
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Affiliations:
- Pavlov University
- Issue: Vol 17, No 2 (2020)
- Pages: 53-60
- Section: Original studies
- URL: https://bakhtiniada.ru/raj/article/view/121661
- DOI: https://doi.org/10.36691/RJA1364
- ID: 121661
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Abstract
Relevance. The insufficient effect of sublingual allergen-specific immunotherapy (SLIT) is caused, first of all, by non-compliance with the treatment regimen and premature treatment termination.
Purpose of the study. Determining the frequency of patient drop-out rate during SLIT with house dust mites (HDM) allergens in children with allergic rhinitis (AR) or AR in combination with bronchial asthma (BA), with an analysis of the drop-out reasons, and approbation of the developed visit-to-visit patient management plan (Plan).
Materials and methods. We analyzed 274 cases of treatment with HDM SLIT in children. 218 patients: 67.4% (147) boys, median age 11.33 years [7.26; 15.46], the proportion of patients with BA 43.1% (94 children) – received HDM SLIT in 2013–2020. 56 patients: 71.4% (40) boys, median age 9.29 years [6.13; 15.93], the proportion of patients with BA 78.6% (44 children) received treatment in accordance with the Plan.
Results. A relatively low frequency of treatment withdrawal was noted in the first 2 years of therapy (2 years after the start of treatment, 72.47% patients continue it). However, only 52.29% complete 3 years of therapy, and 14.67% complete 4 years of therapy. Implementation of the Plan increased patient retention in treatment at the 3rd year of treatment to 69.64% (p=0.031).
Conclusions. Only half of the patients receive the required three-year minimum of treatment.
The daily plan optimizes the patient management schedule for HDM ASIT; reduces patient dropout from treatment and can be recommended for practical healthcare.
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##article.viewOnOriginalSite##About the authors
Olga V. Trusova
Pavlov University
Author for correspondence.
Email: o-tru@mail.ru
ORCID iD: 0000-0002-0854-1536
MD, PhD, Associate professor, Department of Therapy with the course on Allergy and Immunology
Russian Federation, 6–8, L’va Tolstogo str., Saint Petersburg, 197022Andrey V. Kamaev
Pavlov University
Email: andykkam@mail.ru
ORCID iD: 0000-0001-9654-3429
MD, PhD, Associate professor, Department of General Practice (Family Medicine)
Russian Federation, 6–8, L’va Tolstogo str., Saint Petersburg, 197022Irina V. Makarova
Pavlov University
Email: allergist_PI@mail.ru
ORCID iD: 0000-0002-4740-880X
MD, PhD, Associate professor, Department of Therapy with the course on Allergy and Immunology
Russian Federation, 6–8, L’va Tolstogo str., Saint Petersburg, 197022References
- Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention, 2020. Available from: www.ginasthma.org. Ссылка активна на 10.04.2020.
- Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A et al. Allergic Rhinitis and its Impact on Asthma (ARIA). Allergy. 2008;63:8-160. doi: 10.1111/j.1398-9995.2007.01620.x.
- Гайдук ИМ, Коростовцев ДС, Шапорова НЛ, Трусова ОВ, Брейкин ДВ. Современная терапия аллергического ринита у детей: сравнительное исследование топических препаратов. Земский врач. 2012;5(16):25-27 [Gaiduk IM, Korostovtsev DS, Shaporova NL, Trusova OV, Breykin DV. Contemporary therapy of allergic rhinitis in children: a comparative study of topical medications. Zemskiy vrach. 2012;5(16):25-27 (In Russ.)].
- Федеральные клинические рекомендации по проведению аллерген-специфической иммунотерапии. 2103. Доступно по: www.raaci.ru. Ссылка активна на 10.12.2018 [Federal’nye klinicheskie rekomendatsii po provedeniyu allergen-spetsificheskoi immunoterapii. 2013 (In Russ.)].
- Roberts G, Pfaar O, Akdis CA, Ansotegui IJ, Durham SR, Gerth van Wijk R et al. EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis. Allergy. 2018;73:765-798. doi: 10.1111/all.13317.
- Marogna M, Spadolini I, Massolo A, Canonica GW, Passalacqua G. Long-lasting effects of sublingual immunotherapy according to its duration: A 15-year prospective study. Journal of Allergy and Clinical Immunology. 2010;126:969-975. doi: 10.1016/j.jaci.2010.08.030.
- Dhami S, Kakourou A, Asamoah F, Agache I, Lau S, Jutel M et al. Allergen immunotherapy for allergic asthma: A systematic review and meta-analysis. Allergy. 2017;72:1825-1848. doi: 10.1111/all.13208.
- Dhami S, Nurmatov U, Arasi S, Khan T, Asaria M, Zaman H et al. Allergen immunotherapy for allergic rhinoconjunctivitis: A systematic review and meta-analysis. Allergy. 2017;72(11):1597-1631. doi: 10.1111/all.13201.
- Agache I, Lau S, Akdis CA, Smolinska S, Bonini M, Cavkaytar O et al. EAACI Guidelines on Allergen Immunotherapy: House dust mite‐driven allergic asthma. Allergy. 2019;74:855-873. doi: 10.1111/all.13749.
- Nam YH, Lee SK. Physician’s recommendation and explanation is important in the initiation and maintenance of allergen immunotherapy. Patient Preference and Adherence. 2017;11:381-387. doi: 10.2147/PPA.S118368.
- Senna G, Lombardi C, Canonica GW, Passalacqua G. How adherent to sublingual immunotherapy prescriptions are patients? The manufacturers’ viewpoint. J Allergy Clin Immunol. 2010;126:668-669. doi: 10.1016/j.jaci.2010.06.045.
- Savi E, Peveri S, Senna G, Passalacqua G. Causes of SLIT discontinuation and strategies to improve the adherence: a pragmatic approach. Allergy. 2013;68:1193-1195. doi: 10.1111/all.12198.
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