Care with allergen immunotherapy for allergic respiratory diseases in Germany—Predictors and deficits

Abstract

Background: Allergen immunotherapy (AIT) represents the only possibility of causal therapy for allergic respiratory diseases. Although the prevailing high prevalence of allergic diseases and restrictions in the daily lives of patients, AIT is offered to a suboptimal number of patients in Germany.Methods: Insured patients with documented allergic respiratory disease of one of the largest statutory health insurances in Germany, 'DAK-Gesundheit', were contacted by postal mail and asked to participate in the study. In case of written consent, primary and secondary data of patients were collected and analysed. Patient characteristics, predictors of being offered AIT, predictors of performing AIT and guideline-compliant care were analysed.Results: 2505 subjects were included in the VerSITA study. Allergy to tree pollen and native speaking were identified as predictors, which increase the probability of being offered AIT. The probability was significantly decreased by the characteristics allergic rhinitis only, allergic asthma only, age in years, non-German citizenship, no graduation and lower secondary qualification. Significant positive predictors for an AIT to be actually performed were: Allergy to tree pollen and male sex. Predictors that decrease the likelihood that AIT is performed were: only allergic asthma, current smoker, former smoker, age and non-German citizenship. Furthermore, it was possible to identify characteristics in which guideline-compliant patients differed significantly from the rest of the study population. Conclusions:Based on statutory health insurance data and patient survey data, the VerSITA study provides a broad and in-depth overview of the care situation with regard to AIT in Germany and identifies deficits.

Quality of life and healthcare costs of patients with allergic respiratory diseases: a cross-sectional study

“…Most study participants reacted to three or more allergens (63.1%). A more detailed descriptive of the study population has already been published elsewhere [ 45 ].…”

“…A large proportion of individuals with AIT within the routine data period were intentionally recruited for questions regarding the care situation (published elsewhere) [ 19 , 45 ]. The resulting AIT rate in the VerSITA study of 54% within the routine data period is far above the amount that is estimated for Germany and leads to an overestimation of the average costs for AIT medication.…”

High baseline prevalence of atopic comorbidities and medication use in children treated with allergy immunotherapy in the REAl-world effeCtiveness in allergy immunoTherapy (REACT) study

“…The recently published real-world VerSITA study shows that, in Germany, certain groups of people with respiratory diseases are underprivileged in the healthcare system regarding the optimal care of their disease ( 66 ). It appears that AIT is underutilized in individuals with AR, and has been for more than a decade.…”

Mepolizumab for eosinophilic chronic rhinosinusitis, loss of smell and challenges with accessibility to allergen immunotherapy

“…Valbert et al 8,9 evaluated 2505 insured patients with documented allergic respiratory disease in one of the most extensive statutory health insurances in Germany, "DAK-Gesundheit." Patient characteristics, predictors of being offered AIT, predictors of receiving AIT and predictors of guideline-compliant care were evaluated.…”

“…Valbert et al 8,9 evaluated 2505 insured patients with documented allergic respiratory disease in one of the most extensive statutory health insurances in Germany, “DAK‐Gesundheit.” Patient characteristics, predictors of being offered AIT, predictors of receiving AIT and predictors of guideline‐compliant care were evaluated. Predictors of being offered AIT included allergy to tree pollen and native speaking, whereas those with non‐German citizenship or lower educational attainment were less likely to be offered AIT.…”