Patient dropouts from sublingual allergen specific immunotherapy with house dust mites. Solving a problem.

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Abstract


Relevance. The insufficient effect of sublingual allergen-specific immunotherapy (SLIT) is caused, first of all, by non-compliance with the treatment regimen and premature treatment termination.

Purpose of the study. Determining the frequency of patient drop-out rate during SLIT with house dust mites (HDM) allergens in children with allergic rhinitis (AR) or AR in combination with bronchial asthma (BA), with an analysis of the drop-out reasons, and approbation of the developed visit-to-visit patient management plan (Plan).

Materials and methods. We analyzed 274 cases of treatment with HDM SLIT in children. 218 patients: 67.4% (147) boys, median age 11.33 years [7.26; 15.46], the proportion of patients with BA 43.1% (94 children) – received HDM SLIT in 2013–2020. 56 patients: 71.4% (40) boys, median age 9.29 years [6.13; 15.93], the proportion of patients with BA 78.6% (44 children) received treatment in accordance with the Plan.

Results. A relatively low frequency of treatment withdrawal was noted in the first 2 years of therapy (2 years after the start of treatment, 72.47% patients continue it). However, only 52.29% complete 3 years of therapy, and 14.67% complete 4 years of therapy. Implementation of the Plan increased patient retention in treatment at the 3rd year of treatment to 69.64% (p=0.031).

Conclusions. Only half of the patients receive the required three-year minimum of treatment.

The daily plan optimizes the patient management schedule for HDM ASIT; reduces patient dropout from treatment and can be recommended for practical healthcare.

 

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Olga V. Trusova

Pavlov University

Author for correspondence.
Email: o-tru@mail.ru
ORCID iD: 0000-0002-0854-1536

Russian Federation, 6–8, L’va Tolstogo str., Saint Petersburg, 197022

MD, PhD, Associate professor, Department of Therapy with the course on Allergy and Immunology

Andrey V. Kamaev

Pavlov University

Email: andykkam@mail.ru
ORCID iD: 0000-0001-9654-3429

Russian Federation, 6–8, L’va Tolstogo str., Saint Petersburg, 197022

MD, PhD, Associate professor, Department of General Practice (Family Medicine)

Irina V. Makarova

Pavlov University

Email: allergist_PI@mail.ru
ORCID iD: 0000-0002-4740-880X

Russian Federation, 6–8, L’va Tolstogo str., Saint Petersburg, 197022

MD, PhD, Associate professor, Department of Therapy with the course on Allergy and Immunology

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