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日本雪松花粉症舌下免疫疗法依从性的预测因素:一项前瞻性分析。

Predictors of adherence to sublingual immunotherapy for Japanese cedar pollinosis: a prospective analysis.

作者信息

Kikkawa Sayaka, Kamijo Atsushi, Nakagome Kazuyuki, Soma Tomoyuki, Kobayashi Takehito, Uchida Yoshitaka, Kase Yasuhiro, Nagata Makoto

机构信息

Department of Otorhinolaryngology.

Allergy Center.

出版信息

Asian Pac J Allergy Immunol. 2021 Dec;39(4):266-271. doi: 10.12932/AP-200219-0499.

Abstract

BACKGROUND

Sublingual immunotherapy (SLIT) often has low adherence rates.

OBJECTIVE

To provide effective support for SLIT continuation, we investigated potential predictors of SLIT adherence through a prospective analysis of patient characteristics. We excluded evaluation of treatment effect and symptoms during treatment, aiming instead to identify predictors of later dropout or insufficient adherence due to indolence or forgetfulness using only information obtained at initial examination.

METHODS

We provided patients with a questionnaire and monitored self-reported adherence once every 6 months. Cases of dropout for clear reasons were excluded, but cases of dropout or insufficient adherence to SLIT for indolence or forgetfulness were included.

RESULTS

Fifty-three patients receiving SLIT were assessed. Nine patients dropped out after providing a clear reason. Thirty-four patients maintained good adherence. Seven patients continued SLIT but with insufficient adherence, while three patients discontinued SLIT for unclear reasons (indolence or forgetfulness) and these ten individuals were classified as the poor-adherence group. Univariate analysis and multivariate logistic regression analysis of the good-adherence and poor-adherence groups showed age to be a significant predictor of SLIT adherence. Based on analysis of a receiver operating characteristic curve, age < 40.5 years was selected as the optimal cutoff value for predicting poor adherence to SLIT.

CONCLUSIONS

To prevent treatment SLIT discontinuation on account of indolence or forgetfulness, the necessity of longterm treatment continuity should be communicated clearly prior to commencing treatment, especially for patients under 40 years of age.

摘要

背景

舌下免疫疗法(SLIT)的依从率往往较低。

目的

为支持SLIT的持续治疗,我们通过对患者特征进行前瞻性分析,调查了SLIT依从性的潜在预测因素。我们排除了对治疗效果和治疗期间症状的评估,而是仅使用初次检查时获得的信息,旨在识别因懒惰或遗忘导致后期退出或依从性不足的预测因素。

方法

我们为患者提供了一份问卷,并每6个月监测一次自我报告的依从性。明确原因导致退出的病例被排除,但因懒惰或遗忘导致退出或SLIT依从性不足的病例被纳入。

结果

对53例接受SLIT治疗的患者进行了评估。9例患者在给出明确原因后退出。34例患者保持良好依从性。7例患者继续接受SLIT治疗但依从性不足,3例患者因不明原因(懒惰或遗忘)停止SLIT治疗,这10例患者被归为依从性差的组。对依从性好和依从性差的组进行单因素分析和多因素逻辑回归分析,结果显示年龄是SLIT依从性的一个重要预测因素。基于对受试者工作特征曲线的分析,选择年龄<40.5岁作为预测SLIT依从性差的最佳临界值。

结论

为防止因懒惰或遗忘而中断SLIT治疗,在开始治疗前应明确告知患者长期治疗连续性的必要性,尤其是对于40岁以下的患者。

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