Importance of patient’s education in favouring compliance with sublingual immunotherapy

Incorvaia, Cristoforo; Rapetti, Andrea; Scurati, Silvia; Panina-Bordignon, Paola; Capecce, M.; Frati, Franco

doi:10.1111/j.1398-9995.2010.02347.x

Cited by 42 publications

(31 citation statements)

References 5 publications

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“…However, except for the last factor (change in PAR treatment), none of these was associated with a lack of compliance. Improvement in the compliance with allergen immunotherapy, therefore, requires multidisciplinary and integral solutions, including patient education, strict follow-up, and regular contacts before and during treatment [33,37]. A consensual agreement between the patient and the specialist to tailor the schedule [38] and establishing a mechanism to remind the patients to take their medication [39,40] should also improve the compliance outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Other variables associated with the compliance with SLIT have been widely discussed (e.g., teaching the patient to control the illness severity [33]). In the present study, similar aspects (educational measures at the initiation of SLIT and change in the frequency and severity of allergic rhinitis) and other not previously reported variables (e.g., medical consultation length or use of corticosteroids as a treatment before the SLIT) were associated with compliance with SLIT in the bivariate analysis.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Comprehensive Study of Patients’ Compliance with Sublingual Immunotherapy in House Dust Mite Perennial Allergic Rhinitis

Malet¹,

Azpeitia

Gutiérrez

et al. 2016

Adv Ther

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comprehensive Study of Patients’ Compliance with Sublingual Immunotherapy in House Dust Mite Perennial Allergic Rhinitis

Malet¹,

Azpeitia

Gutiérrez

et al. 2016

Adv Ther

View full text Add to dashboard Cite

show abstract

“…Potential side effects and problems related to the use of SLIT were also discussed. A lower dropout rate was observed after 1 year in the "educated" group versus the group that received only detailed instructions about SLIT self-administration [79]. An educational plan and regular phone calls to remind patients about follow-up appointments, versus provision of only minimal instructions to a control group, was carried out in another SLIT study.…”

Section: Educational Plansmentioning

confidence: 92%

Allergen Immunotherapy Adherence in the Real World: How Bad Is It and How Can It Be Improved?

Senna

Caminati

Lockey

2014

Curr Treat Options Allergy

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Opinion StatementAllergen immunotherapy (AIT) is the only available causal treatment for allergic respiratory diseases; however, data demonstrate a high discontinuation rate for both subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT). The complex mechanism of action of allergen immunotherapy (AIT) includes an interaction of innate and adaptive immune processes, resulting in immune tolerance, as illustrated by a decrease in specific immunoglobulin (Ig)-E, an increase in specific IgG1 and IgG4, and inhibition of inflammation involving mast cells, basophils, and eosinophils. This induction of immune tolerance leads to a significant improvement in symptoms and decreased medication scores. A 3-to 5-year course of AIT is required to obtain this disease-modifying effect, which substantially differentiates AIT frompharmacologic treatment. A carry-over effect can persist for up to 12 years. Furthermore, AIT may prevent the onset of asthma in patients with allergic rhinitis, as well as decreasing the onset of new sensitizations to inhalant allergens. Several meta-analyses and controlled studies, involving adult and pediatric subjects, have indicated that both sublingual immunotherapy (SLIT) and subcutaneous immunotherapy (SCIT) are relatively safe, effective, and well tolerated. AIT may also have a positive impact on the cost to the healthcare system, as evidence indicates the cost-benefit of such treatment. Adherence to AIT is crucial for a positive clinical outcome and non-adherence represents a major drawback for such therapy. It actually concerns not only AIT but also various pharmacologic treatments for allergic respiratory diseases, as well as for other chronic illnesses. The issue of non-adherence is an emerging and worldwide problem for chronic diseases and could be an important factor responsible for an overall decrease in treatment efficacy and increased rates of hospitalization, morbidity, and mortality. This review provides an overview of the different reasons that may account for the low adherence rate for AIT. Some of these reasons can be related to the patient's age when they begin such therapy, the allergic disease being treated, and questions about the efficacy, costs, inconvenience, and safety of AIT. Well-structured educational programs,especially by healthcare professionals, the print media, and the Internet, are needed to improve adherence to AIT.

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“…Also, receiving detailed information on special educational programs to the patient seems to be helpful in increasing adherence. The not well-trained patient will lead to trivial side-effects to SLIT such as oral and gastrointestinal local reactions, and this will lead to sudden withdrawal of the treatment [61]. …”

Section: Adherencementioning

confidence: 99%

Sublingual Immunotherapy in Allergic Rhinitis: Efficacy, Safety, Adherence and Guidelines

Aboshady

Elghanam

2014

Clin Exp Otorhinolaryngol

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Allergic rhinitis (AR) is a globally increasing health problem affecting the quality of life. Specific immunotherapy is an available causal treatment changing the basic allergic mechanisms of the disease. Over one hundred years, subcutaneous immunotherapy (SCIT) was developed and proved its efficacy but many adverse effects were recorded including anaphylaxis. In 1986, sublingual immunotherapy (SLIT) was introduced as an alternative solution to solve this problem. Our study aims to discuss SLIT from the points of efficacy, safety, adherence and guidelines developed. A literature search was conducted in Medline/PubMed and the Cochrane Library in January 2013 using the keywords "allergic rhinitis, sublingual immunotherapy, efficacy, safety, compliance, adherence, guidelines." All types of publications were included. We augmented our study by searching the reference lists of identified reviews. SLIT has been established in many guidelines as an evidence-based effective treatment in AR with safer profile than SCIT. The meta-analyses confirmed its efficacy and showed a significant reduction in both symptoms and medication scores. The most common recorded adverse effects were minor local effects in the mouth, gastrointestinal reactions with few cases of anaphylaxis and no fatality. Adherence is more favorable for SLIT mainly because it is safe, noninvasive and easily taken at home. We support the call to conduct large multi-centric studies to gain more statistical power and overcome the problem of heterogeneity observed in the meta-analyses.

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Importance of patient’s education in favouring compliance with sublingual immunotherapy

Cited by 42 publications

References 5 publications

Comprehensive Study of Patients’ Compliance with Sublingual Immunotherapy in House Dust Mite Perennial Allergic Rhinitis

Comprehensive Study of Patients’ Compliance with Sublingual Immunotherapy in House Dust Mite Perennial Allergic Rhinitis

Allergen Immunotherapy Adherence in the Real World: How Bad Is It and How Can It Be Improved?

Sublingual Immunotherapy in Allergic Rhinitis: Efficacy, Safety, Adherence and Guidelines

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