Valbert Frederik, Neusser Silke, Pfaar Oliver, Klimek Ludger, Sperl Annette, Werfel Thomas, Hamelmann Eckard, Riederer Cordula, Wobbe-Ribinski Stefanie, Hillerich Vivienne, Neumann Anja, Wasem Jürgen, Biermann-Stallwitz Janine
Institute for Healthcare Management and Research, University Duisburg-Essen, Essen, Germany.
Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany.
Clin Exp Allergy. 2022 Dec;52(12):1422-1431. doi: 10.1111/cea.14172. Epub 2022 May 18.
Allergen immunotherapy (AIT) represents the only possibility of causal therapy for allergic respiratory diseases. Although the prevailing high prevalence of allergic diseases and restrictions in the daily lives of patients, AIT is offered to a suboptimal number of patients in Germany.
Insured patients with documented allergic respiratory disease of one of the largest statutory health insurances in Germany, 'DAK-Gesundheit', were contacted by postal mail and asked to participate in the study. In case of written consent, primary and secondary data of patients were collected and analysed. Patient characteristics, predictors of being offered AIT, predictors of performing AIT and guideline-compliant care were analysed.
2505 subjects were included in the VerSITA study. Allergy to tree pollen and native speaking were identified as predictors, which increase the probability of being offered AIT. The probability was significantly decreased by the characteristics allergic rhinitis only, allergic asthma only, age in years, non-German citizenship, no graduation and lower secondary qualification. Significant positive predictors for an AIT to be actually performed were: Allergy to tree pollen and male sex. Predictors that decrease the likelihood that AIT is performed were: only allergic asthma, current smoker, former smoker, age and non-German citizenship. Furthermore, it was possible to identify characteristics in which guideline-compliant patients differed significantly from the rest of the study population.
Based on statutory health insurance data and patient survey data, the VerSITA study provides a broad and in-depth overview of the care situation with regard to AIT in Germany and identifies deficits.
变应原免疫疗法（AIT）是过敏性呼吸道疾病病因治疗的唯一可能方法。尽管过敏性疾病普遍高发且给患者日常生活带来诸多限制，但在德国，接受AIT治疗的患者数量未达理想水平。
通过邮政信件联系德国最大的法定健康保险公司之一“DAK-Gesundheit”承保的有过敏性呼吸道疾病记录的患者，邀请其参与研究。获得书面同意后，收集并分析患者的初级和二级数据。分析患者特征、接受AIT治疗的预测因素、进行AIT治疗的预测因素以及符合指南的治疗情况。
2505名受试者纳入了VerSITA研究。对树花粉过敏和母语为德语被确定为预测因素，这会增加接受AIT治疗的可能性。仅患有过敏性鼻炎、仅患有过敏性哮喘、年龄、非德国国籍、未毕业和初中以下学历等特征会显著降低这种可能性。实际进行AIT治疗的显著正向预测因素为：对树花粉过敏和男性。降低AIT治疗可能性的预测因素为：仅患有过敏性哮喘、当前吸烟者、既往吸烟者、年龄和非德国国籍。此外，还能够确定符合指南的患者与研究人群其他部分有显著差异的特征。
基于法定健康保险数据和患者调查数据，VerSITA研究对德国AIT治疗的护理情况提供了广泛而深入的概述，并指出了不足之处。
