Sánchez J
Group of Clinical and Experimental Allergy, IPS Universitaria, University of Antioquia, Medellin, Colombia; Foundation for The Development of Medical and Biological Sciences (FUNDEMEB), Cartagena, Colombia; Institute for Immunological Research, University of Cartagena, Cartagena, Colombia.
Allergol Immunopathol (Madr). 2015 Sep-Oct;43(5):436-41. doi: 10.1016/j.aller.2014.04.011. Epub 2014 Sep 8.
Immunotherapy has shown to be an effective treatment for the management of some IgE-mediated allergies. However, due to its long duration, a high number of patients withdraw from it before completion.
Explore if allowing patients to select the route of immunotherapy, educational sessions and strict follow-up could improve treatment compliance.
Patients consulting allergy service were divided into two groups; if they chose the route of administration of immunotherapy, they were selected for the active group; if their physician decided, they were selected for the control group. All patients had to attend the allergy service monthly for control. Before the first application of immunotherapy, all patients received an educative session about the benefits and risks of the treatment. Patients in the active group received an additional session about subcutaneous and sublingual routes and they chose the most appropriate according to their personal characteristics.
A total of 204 patients were in the active group and 103 were included in the control group. At six months, a total of 46 patients withdrew from immunotherapy during follow-up, 24 (11%) in the active group and 22 (21%) in the control group (p=0.02). In the active group we observed no statistically significant difference in adherence between those who preferred subcutaneous or sublingual immunotherapy; however in the control group, the drop out of sublingual immunotherapy was significantly higher than those who received subcutaneous (p=0.05).
Educational sessions, strict follow-up and considering personal preferences of patients could improve adherence to allergen immunotherapy.
免疫疗法已被证明是治疗某些IgE介导的过敏症的有效方法。然而，由于其疗程较长，大量患者在疗程结束前退出。
探讨允许患者选择免疫疗法的途径、开展教育课程以及严格随访是否能提高治疗依从性。
咨询过敏服务的患者被分为两组；如果他们选择免疫疗法的给药途径，则被选入主动组；如果由其医生决定，则被选入对照组。所有患者必须每月到过敏服务部门进行复查。在首次进行免疫疗法之前，所有患者都接受了一次关于治疗益处和风险的教育课程。主动组的患者还额外接受了一次关于皮下和舌下途径的课程，并根据个人特点选择最合适的途径。
主动组共有204名患者，对照组纳入103名患者。在六个月时，共有46名患者在随访期间退出免疫疗法，主动组24名（11%），对照组22名（21%）（p=0.02）。在主动组中，我们观察到倾向于皮下或舌下免疫疗法的患者在依从性方面没有统计学上的显著差异；然而在对照组中，舌下免疫疗法的退出率明显高于接受皮下免疫疗法的患者（p=0.05）。
教育课程、严格随访以及考虑患者的个人偏好可以提高对变应原免疫疗法的依从性。
