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Causes of SLIT discontinuation and strategies to improve the adherence: a pragmatic approach
Author(s) -
Savi E.,
Peveri S.,
Senna G.,
Passalacqua G.
Publication year - 2013
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1111/all.12198
Subject(s) - discontinuation , medicine , slit , medical prescription , sublingual immunotherapy , patient education , pediatrics , physical therapy , surgery , immunotherapy , family medicine , psychology , nursing , cancer , neuroscience
Sublingual immunotherapy ( SLIT ) is often discontinued, and many patients do not renew the prescription. We evaluated the reasons for discontinuation and set up an educational/follow‐up plan to improve the adherence. In a first phase, the adherence at 4 months was directly assessed. Based on those results, an action plan (education, frequent contacts, and strictly scheduled visits) was developed and tested in other patients. A group of matched patients did not undergo the follow‐up plan (controls). In the first phase, involving 252 subjects, at 4 months, there were 30% dropouts, mainly due to side‐effects. In the second phase, 149 patients underwent education/follow‐up and 90 received no intervention. In the first group, discontinuations at 4 months were 5%, vs 18% in the controls ( P = 0.01). After one year, 12% of patients were lost in the first group and 35% in the control group ( P < 0.001). An adequate education and a strict follow‐up can significantly reduce SLIT 's discontinuations.