Patient management plan for sublingual allergen specific immunotherapy with birch pollen allergen and the maintenance of patient compliance

Abstract

BACKGROUND:Sublingual allergen-specific immunotherapy (SLIT) inefficiencie is mainly caused by non-compliance with the treatment regimen and premature treatment termination.
 AIM:Frequency and causes of dropouts determination in children receiving SLIT with birch pollen according to the pre-coseasonal protocol, and approbation of the developed visit-to-visit patient management plan (Plan).
 MATERIALS AND METHODS:332 cases of treatment with birch pollen in children are analyzed. 290 patients (72.1% boys, aged 518 years (9.82 years [5.93; 14.67]), received SLIT with birch pollen in 20122019. 42 patients received SLIT according to the Plan (69% boys, 8.95 years old [5.38; 11.79]) in 20172019.
 RESULTS:A low dropout frequency was noted in the 1st and 2nd year of therapy (2 years after the start of treatment, 85% patients continue it). However, only 63.1% complete 3 years of therapy, and 11% 4 years of therapy. It has been shown that experienced allergists have more efficient patient retention. The implementation of the Plan increased patient retention in treatment at the 3rdyear of treatment up to 82.9% (p=0.02).
 CONCLUSION:The study confirmed the main reasons for the withdrawal of patients from SLIT: doubts about the effectiveness, cost and side effects. A low dropout frequency was shown according to the results of the 1stand 2ndyears of therapy, but only a small proportion of patients (11%) receive 4 or more courses of therapy. Visit-to-visit Plan optimizes the patients management, reduces patients withdrawal from treatment and can be recommended for practical healthcare.