Causes of SLIT discontinuation and strategies to improve the adherence: a pragmatic approach

• Published in: Allergy (Copenhagen) 2013-09, Vol.68 (9), p.1193-1195
• Main Authors: Savi, E., Peveri, S., Senna, G., Passalacqua, G.
• Format: Article
• Language: English
• Subjects: adherence; Adolescent; Adult; Asthma - immunology; Asthma - therapy; Child; Child, Preschool; Compliance; Desensitization, Immunologic; discontinuation; Female; follow‐up; Humans; Immunotherapy; Male; Medication Adherence; Middle Aged; Rhinitis, Allergic, Seasonal - immunology; Rhinitis, Allergic, Seasonal - therapy; sublingual immunotherapy; Sublingual Immunotherapy - adverse effects; Young Adult
• ISSN: 0105-4538; 1398-9995
• DOI: 10.1111/all.12198

Sublingual immunotherapy (SLIT) is often discontinued, and many patients do not renew the prescription. We evaluated the reasons for discontinuation and set up an educational/follow‐up plan to improve the adherence. In a first phase, the adherence at 4 months was directly assessed. Based on those results, an action plan (education, frequent contacts, and strictly scheduled visits) was developed and tested in other patients. A group of matched patients did not undergo the follow‐up plan (controls). In the first phase, involving 252 subjects, at 4 months, there were 30% dropouts, mainly due to side‐effects. In the second phase, 149 patients underwent education/follow‐up and 90 received no intervention. In the first group, discontinuations at 4 months were 5%, vs 18% in the controls (P = 0.01). After one year, 12% of patients were lost in the first group and 35% in the control group (P