Evaluation of Adherence to Sublingual Immunotherapy Treatment for Allergic Rhinitis

Abstract

Introduction: Allergic rhinitis is an inflammatory condition of the inside of the nose, mediated by Immunoglobulin E, in response to an inhaled allergen. Clinically, it presents with nasal obstruction, runny nose, nasal and/or eye itching, and sneezing. For its symptomatic treatment, environmental control is essential and nasal steroids are the gold standard in the adult and pediatric population. Another form of treatment is immunotherapy, changing the response to the allergen via the immune tolerance mechanism. Subcutaneous immunotherapy (SCIT) is applied weekly to monthly, in contrast to sublingual immunotherapy (SLIT), which is performed daily by the patient. For an effective treatment of chronic disease, the period of treatment and discipline in maintaining it must be respected. Objective: Analyze the main reasons why the patient gives up treatment with sublingual immunotherapy. Methods: This prospective and linear study evaluated patients at the IPO Hospital (Instituto Paranaense de Otorrinolaringologia, Curitiba, Brazil) who were undergoing treatment with sublingual immunotherapy for allergic rhinitis and who, for some reason, discontinued the recommended treatment. Results: The study sample consisted of 148 patients, 79 women and 69 men. The mean duration of treatment for patients who dropped out was 8.3 months. The cost was the most cited reason, which was mentioned by 47.3% of patients; followed by irregularity of use and absence of improvement with treatment, both with 23% each. The presence of side effects was included as a reason by 9.5% and still, 25% of respondents cited several other reasons as obstacles to treatment. Conclusion: The present study concluded that the main barriers found for treatment adherence are long treatment duration, cost, and regularity of use.