Adherence to treatment in allergic respiratory diseases

Baiardini, Ilaria; Novakova, Silviya; Mihăicuță, Ștefan; Oğuzülgen, I. Kıvılcım; Canonica, Giorgio Walter

doi:10.1080/17476348.2019.1554438

Cited by 21 publications

(23 citation statements)

References 77 publications

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“…Nonpersistence to AIT is associated with high costs and poor clinical outcomes [36,37]. Hence, adherence to treatment is essential for improving the long-term effectiveness of treatment in patients with allergic respiratory diseases, reducing healthcare costs, and for minimizing the disease's burden on a patient's life [38].…”

Section: Discussionmentioning

confidence: 99%

Real world effectiveness and cost consequences of grass pollen SCIT compared with SLIT and symptomatic treatment

2021

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Purpose Real-world evidence (RWE) with regard to allergen-specific immunotherapy (AIT) adherence is increasingly available. Economic modelling has already shown AIT to be cost-effective in the treatment of allergic rhinitis compared with symptomatic treatment. However, analyzing sublingual (SLIT) and subcutaneous (SCIT) immunotherapeutic approaches based on RWE adherence data are not available for Germany. This analysis outlines the cost-effectiveness of SCIT compared with SLIT as well as a symptomatic treatment modality on the basis of recent RWE adherence data. Methods A Markov model, with predefined disease stages and a time period of 9 years, was adapted for this analysis. A 6-grass subcutaneous allergoid SCIT preparation and a 5-grass pollen SLIT tablet was employed as AIT administrations. Quality-adjusted life years (QALYs) were calculated based on symptom scores and used as the effectiveness variable. Total costs and cost effectiveness of SCIT, SLIT and symptomatic treatment (ST) were calculated. Model uncertainties were estimated by means of additional sensitivity analyses. Applied discount rate was 3%. Results Both SCIT and SLIT preparations proved superior compared to symptomatic treatment with regard to effectiveness. Although more expensive, AIT also proved to be cost-effective. A direct comparison of SCIT (Allergovit®) and SLIT (Oralair®) showed lower total costs for SCIT treatment over the study period of 9 years (SCIT 1779 € versus SLIT 2438 €) and improved effectiveness (SCIT 7.17 QALYs versus SLIT 7.11 QALYs). Conclusion AIT represents a cost-effective treatment option for patients with allergic rhinitis compared with symptomatic treatment. SCIT appeared to be dominant and cost-effective, due in particular to higher patient adherence and lower drug costs.

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Section: Discussionmentioning

confidence: 99%

Real world effectiveness and cost consequences of grass pollen SCIT compared with SLIT and symptomatic treatment

2021

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“…The medications commonly used for AR have shown by objective measures to be effective and safe even for prolonged use. However, regarding children, parents/ caregivers are often skeptical and unwilling to follow long-term treatments, which results in considerably low adherence [27]. Nasal irrigations (particularly those with normal saline) have long been used to remove mucus from the upper respiratory tract, as they are safe, tolerable and more easily acceptable by parents/caregivers.…”

Section: Discussionmentioning

confidence: 99%

Effect of nasal irrigation on allergic rhinitis control in children; complementarity between CARAT and MASK outcomes

Mitsias

Dimou

Lakoumentas

et al. 2020

Clin Transl Allergy

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Background: Nasal irrigations (NI) are increasingly used as an over-the-counter adjunctive treatment for allergic rhinitis (AR), but clinical studies on their effectiveness are limited.Methods: An open-label, controlled, non-randomized, real-life study was conducted to evaluate the effectiveness of NI with a new hypertonic solution as add-on treatment for AR. Children and adolescents with AR were prescribed symptomatic treatment. The active group also received an additional sea-water NI solution supplemented with algae extracts. The primary endpoint was symptom control, assessed by the control of allergic rhinitis and asthma test (CARAT) questionnaires. Moreover, the MASK/Allergy Diary was used to track symptoms and daily medication use that were combined in a novel total symptom/medication score (TSMS). Results:We assessed 76 patients. Overall, there was a significant improvement of CARAT results (median Z-score change of 1.1 in the active/NI group vs. 0.4 in the control group; p = 0.035). Among patients > 12 years old (n = 51), there was a significant improvement in CARAT10 results among participants receiving NI (21.0 to 25.5; p < 0.001), but not in the regular treatment group (21.5 to 24.0; p = 0.100). For children < 12 years old (n = 25), the ΝΙ group had significantly improved symptom control (CARATKids results: 5.0 to 2.0; p = 0.002), in contrast to the control group (4.0 to 2.5; p = 0.057). MASK data on allergic symptoms were comparable between groups. However, the NI group had lower TSMS, more days with < 20% symptoms and fewer days using symptomatic treatment (26.9% vs. 43.5%; p = 0.005). Conclusion:Addition of NI with a sea-water solution to regular treatment improved AR symptom control. CARAT questionnaires and MASK application can be useful outcome tools in real-life studies. Active (n: 55) Control (n: 23) p-value * Percentage (%) of days on treatment 0.005 Median (25-75 percentile) 26.9 (19.1-40.7) 43.5 (31.0-61.2) Medication score a 0.006 Median (25-75 percentile) 16.7 (10.7-25.0) 25.7 (17.3-35.7)

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“…However, sharing the treatment approach and the reasons behind it with the patients may enhance their disease awareness. 37,38 When possible under a clinical perspective, discussing with the patients about different options in terms of device or treatment schedule and exploring their preferences and expectations may increase their engagement in asthma management. 39 In any case, a tailored asthma action plan, including prevention and management of asthma exacerbation, should always be shared with the patients.…”

Section: Mild-to-moderate Asthma -Unmet Needs and Potential Strategiesmentioning

confidence: 99%

Uncontrolled Asthma: Unmet Needs in the Management of Patients

Caminati

Vaia

Furci

et al. 2021

JAA

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The recent scientific research has provided clinicians with the tools for substantially upgrading the standard of care in the field of bronchial asthma. Nevertheless, satisfactory asthma control still remains an unmet need worldwide. Identifying the major determinants of poor control in different asthma severity levels represents the first step towards the improvement of the overall patients’ management. The present review aims to provide an overview of the main unmet needs in asthma control and of the potential tools for overcoming the issue. Implementing a personalized medicine approach is essential, not only in terms of pharmacological treatments, biologic drugs or sophisticated biomarkers. In fact, exploring the complex profile of each patient, from his inflammation phenotype to his preferences and expectations, may help in filling the gap between the big potential of currently available treatments and the overall unsatisfactory asthma control. Telemedicine and e-health technologies may provide a strategy to both optimize disease assessment on a regular basis and enhance patients’ empowerment in managing their asthma. Increasing patients’ awareness as well as the physicians’ knowledge about asthma phenotypes and treatment options besides corticosteroid probably represent the key and more difficult goals of all the players involved in asthma management at every level.

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Adherence to treatment in allergic respiratory diseases

Cited by 21 publications

References 77 publications

Real world effectiveness and cost consequences of grass pollen SCIT compared with SLIT and symptomatic treatment

Real world effectiveness and cost consequences of grass pollen SCIT compared with SLIT and symptomatic treatment

Effect of nasal irrigation on allergic rhinitis control in children; complementarity between CARAT and MASK outcomes

Uncontrolled Asthma: Unmet Needs in the Management of Patients

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