Factors involved in adherence to sublingual and subcutaneous immunotherapy in patients from the Allergy Service at a health institution in Medellin-Colombia

Medicina y Laboratorio

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Title Factors involved in adherence to sublingual and subcutaneous immunotherapy in patients from the Allergy Service at a health institution in Medellin-Colombia
Factores involucrados en la adherencia a la inmunoterapia sublingual y subcutánea en pacientes del Servicio de Alergología de una institución de salud en Medellín-Colombia
 
Creator Acevedo-Vásquez, Ana Milena
Farfán-Plata, Rosa
Ramírez-Giraldo, Ruth
Cardona-Villa, Ricardo
 
Subject therapy adherence, immunotherapy, sublingual, discontinuation of therapy.
adherencia al tratamiento, inmunoterapia, sublingual, abandono del tratamiento.
 
Description Introduction. Allergic diseases in the world have increased in the last century, requiring novel treatments to improve the quality of life of patients. As a result, immunotherapy has emerged as a therapeutic option. The aim of this study was to identify aspects of adherence to sublingual (SLIT) and subcutaneous (SCIT) immunotherapy and reasons for non-adherence. Materials and methods. We present a retrospective study of patients with allergic diseases (rhinitis, asthma or atopic dermatitis) who initiated SCIT or SLIT at the allergology clinic in a health institution in Medellin, Colombia. Absolute and relative distributions, descriptive statistics and Chi square test were used for statistical analysis. Results. A total of 144 patients were selected (SCIT=84.7%; SLIT=15.3%). From the total of patients, 38.9% were considered adherent; no significant differences were found in adherence according to the route of administration (p=0.833). The most important reason for selecting the type of immunotherapy was medical recommendation. Of the non-adherent patients, 95.5% (n=84) discontinued the treatment. Sociodemographic characteristics of the two immunotherapy groups were relatively similar, with no significant differences. A significant difference was found between the service provided by the health institution and discontinuation of treatment, being greater for the group treated with SLIT (38.5%; p=0.007). Conclusion. The main cause of discontinuation of immunotherapy was the lack of approval for funding by the Health Promoting Agencies (53.6%).
Introducción. Las enfermedades alérgicas en el mundo han aumentado en el último siglo, requiriendo a su vez nuevos tratamientos que permitan mejorar la calidad de vida de los pacientes; como respuesta, la inmunoterapia ha surgido como una opción terapéutica. El objetivo de este estudio fue identificar aspectos de la adherencia a la inmunoterapia sublingual (ITSL) y subcutánea (ITSC), y los motivos de abandono. Materiales y métodos. Estudio descriptivo retrospectivo de pacientes con enfermedades alérgicas (rinitis, asma o dermatitis atópica) que iniciaron inmunoterapia, por vía subcutánea o sublingual, en el Servicio de Alergología de una institución de salud de la ciudad de Medellín, Colombia. Para el análisis estadístico se utilizaron distribuciones absolutas, relativas, medidas de resumen y la prueba Chi cuadrado de independencia. Resultados. Se incluyeron 144 pacientes (ITSC=84,7%;ITSL=15,3%). El 38,9% de los pacientes fueron considerados adherentes; no se hallaron diferencias significativas en la adherencia según la vía de administración (p=0,833). La razón más importante para la selección de la vía de la inmunoterapia en ambos grupos fue la recomendación médica. De los pacientes no adherentes, el 95,5% (n=84) abandonaron el tratamiento. Las características sociodemográficas de los dos grupos de inmunoterapia fueron relativamente similares, sin diferencias significativas. Se encontró una diferencia significativa entre el servicio prestado por la institución en salud y el abandono al tratamiento, siendo mayor para el grupo tratado con ITSL (38,5%; p=0,007). Conclusión. La principal causa de abandono de la terapia fue la no autorización del tratamiento por parte de las Entidades Promotoras de Salud (53,6%).
 
Publisher EDIMECO S.A.
 
Date 2020-09-29
 
Type info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
 
Format application/pdf
 
Identifier https://medicinaylaboratorio.com/index.php/myl/article/view/338
10.36384/01232576.338
 
Source Medicina & Laboratorio; Vol. 24 No. 4 (2020); 307-316
Medicina y Laboratorio; Vol. 24 Núm. 4 (2020); 307-316
2500-7106
0123-2576
 
Language spa
 
Relation https://medicinaylaboratorio.com/index.php/myl/article/view/338/323
/*ref*/Peterson B, Saxon A. Global increases in allergic respiratory disease: the possible role of diesel exhaust particles. Ann Allergy Asthma Immunol 1996;77:263-270. https://doi.org/10.1016/S1081-1206(10)63318-2. 2. Barnes PJ, Jonsson B, Klim JB. The costs of asthma. Eur Respir J 1996;9:636-642. https://doi.org/10.1183/09031936.96.09040636. 3. Maziak W, Behrens T, Brasky TM, Duhme H, Rzehak P, Weiland SK, et al. Are asthma and allergies in children and adolescents increasing? Results from ISAAC phase I and phase III surveys in Munster, Germany. Allergy 2003;58:572-579. https://doi.org/10.1034/j.1398-9995.2003.00161.x. 4. Meltzer EO, Blaiss MS, Derebery MJ, Mahr TA, Gordon BR, Sheth KK, et al. Burden of allergic rhinitis: results from the pediatric allergies in America survey. J Allergy Clin Immunol 2009;124:S43-70. https://doi.org/10.1016/j.jaci.2009.05.013. 5. Weidinger S, Novak N. Atopic dermatitis. Lancet 2016;387:1109-1122. https://doi.org/10.1016/S0140-6736(15)00149-X. 6. Jang HJ, Hwang S, Ahn Y, Lim DH, Sohn M, Kim JH. Family quality of life among families of children with atopic dermatitis. Asia Pac Allergy 2016;6:213-219. https://doi.org/10.5415/apallergy.2016.6.4.213. 7. Tortajada-Girbés M, Mesa Del Castillo M, Larramona H, Lucas JM, Álvaro M, Tabar AI, et al. Evidence in immunotherapy for paediatric respiratory allergy: Advances and recommendations. Allergol Immunopathol 2016;44(Suppl1):1-32. https://doi.org/10.1016/j.aller.2016.09.001. 8. Claes C, Mittendorf T, Graf von der Schulenburg JM. [Persistence and frequency of prescriptions of subcutaneous allergen-specific immunotherapy (SCIT) prescribed within the German statutory health insurance]. Med Klin (Munich) 2009;104:536-542. https://doi.org/10.1007/s00063-009-1113-8. 9. Bahceciler NN, Galip N. Comparing subcutaneous and sublingual immunotherapy: what do we know? Curr Opin Allergy Clin Immunol 2012;12:640-647. https://doi.org/10.1097/ACI.0b013e328358d5f2. 10. Abramson MJ, Puy RM, Weiner JM. Injection allergen immunotherapy for asthma. Cochrane Database Syst Rev 2010:CD001186. https://doi.org/10.1002/14651858.CD001186.pub2. 11. Bender BG, Oppenheimer J. The special challenge of nonadherence with sublingual immunotherapy. J Allergy Clin Immunol Pract 2014;2:152-155. https://doi.org/10.1016/j.jaip.2014.01.003. 12. Reisacher WR, Visaya JM. Patient adherence to allergy immunotherapy. Curr Opin Otolaryngol Head Neck Surg 2013;21:256-262. https://doi.org/10.1097/MOO.0b013e32835f8048. 13. Kiel MA, Roder E, Gerth van Wijk R, Al MJ, Hop WC, Rutten-van Molken MP. Real-life compliance and persistence among users of subcutaneous and sublingual allergen immunotherapy. J Allergy Clin Immunol 2013;132:353-360. https://doi.org/10.1016/j.jaci.2013.03.013. 14. Hsu NM, Reisacher WR. A comparison of attrition rates in patients undergoing sublingual immunotherapy vs subcutaneous immunotherapy. Int Forum Allergy Rhinol 2012;2:280-284. https://doi.org/10.1002/alr.21037. 15. Stokes SC, Quinn JM, Sacha JJ, White KM. Adherence to imported fire ant subcutaneous immunotherapy. Ann Allergy Asthma Immunol 2013;110:165-167. https://doi.org/10.1016/j.anai.2012.11.010. 16. Passalacqua G, Baiardini I, Senna G, Canonica GW. Adherence to pharmacological treatment and specific immunotherapy in allergic rhinitis. Clin Exp Allergy 2013;43:22-28. https://doi.org/10.1111/j.1365-2222.2012.04052.x. 17. Bousquet J, Demoly P. Compliance and convenience to immunotherapy. Arb Paul Ehrlich Inst Bundesinstitut Impfstoffe Biomed Arzneim Langen Hess 2009;96:289-295. 18. Koberlein J, Kothe AC, Schaffert C. Determinants of patient compliance in allergic rhinoconjunctivitis. Curr Opin Allergy Clin Immunol 2011;11:192-199. https://doi.org/10.1097/ACI.0b013e3283466fcb. 19. Antico A. Long-term adherence to sublingual therapy: literature review and suggestions for management strategies based on patients' needs and preferences. Clin Exp Allergy 2014;44:1314-1326. https://doi.org/10.1111/cea.12362. 20. Pitsios C, Dietis N. Ways to increase adherence to allergen immunotherapy. Curr Med Res Opin 2019;35:1027-1031. https://doi.org/10.1080/03007995.2018.1552044. 21. Manzotti G, Riario-Sforza GG, Dimatteo M, Scolari C, Makri E, Incorvaia C. Comparing the compliance to a short schedule of subcutaneous immunotherapy and to sublingual immunotherapy during three years of treatment. Eur Ann Allergy Clin Immunol 2016;48:224-227. 22. Lemberg ML, Berk T, Shah-Hosseini K, Kasche EM, Mosges R. Sublingual versus subcutaneous immunotherapy: patient adherence at a large German allergy center. Patient Prefer Adherence 2017;11:63-70. https://doi.org/10.2147/PPA.S122948. 23. Sieber J, De Geest S, Shah-Hosseini K, Mosges R. Medication persistence with long-term, specific grass pollen immunotherapy measured by prescription renewal rates. Curr Med Res Opin 2011;27:855-861. https://doi.org/10.1185/03007995.2011.559538. 24. Lombardi C. What is the factor that improves adherence to allergen-specific immunotherapy? A secretary! Ann Allergy Asthma Immunol 2015;114:530-531. https://doi.org/10.1016/j.anai.2015.03.013. 25. Leader BA, Rotella M, Stillman L, DelGaudio JM, Patel ZM, Wise SK. Immunotherapy compliance: comparison of subcutaneous versus sublingual immunotherapy. Int Forum Allergy Rhinol 2016;6:460-464. https://doi.org/10.1002/alr.21699. 26. Senna G, Crivellaro MA, Bonadonna P, Dama AR, Schiappoli M, Passalaqua. Optimal dosing of allergen immunotherapy: efficacy, safety, long-lasting effect. Eur Ann Allergy Clin Immunol 2003;35:386-392. 27. Schmitt J, Schwarz K, Stadler E, Wüstenberg EG. Allergy immunotherapy for allergic rhinitis effectively prevents asthma: Results from a large retrospective cohort study. J Allergy Clin Immunol 2015;136:1511-1516. https://doi.org/10.1016/j.jaci.2015.07.038. 28. Jutel M, Brüggenjürgen B, Richter H, Vogelberg C. Real-world evidence of subcutaneous allergoid immunotherapy in house dust mite-induced allergic rhinitis and asthma. Allergy 2020;75:2046-2054. https://doi.org/10.1111/all.14240. 29. Senna G, Caminati M, Lockey RF. Allergen immunotherapy adherence in the real world: How bad is it and how can it be improved? Curr Treat Options Allergy 2015;2:39-53. https://doi.org/10.1007/s40521-014-0037-6.
 
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