Rhinitis, sinusitis, and upper airway diseaseReal-life compliance and persistence among users of subcutaneous and sublingual allergen immunotherapy
Section snippets
Patients and setting
Using the World Health Organization (WHO) Anatomical and Therapeutic Class code for allergen immunotherapy, V01A, we identified all patients aged 18 years or older in the PHARMO Record Linkage System who first started immunotherapy between January 1, 1994, and December 31, 2009 (n = 7851). No prescription of immunotherapy in the 3 years preceding the start of the first course (the index course) of immunotherapy was allowed to avoid any role of long-term effects of previous courses of
Patient and treatment characteristics
Immunotherapy users were, on average, in their fourth decade of life, with a slight predominance of female sex. Users had a slightly higher SES than the general population (P < .001), as displayed in Table I. Sixty-eight percent of SCIT prescriptions and 83% of SLIT prescriptions came from general practitioners, whereas 14% of SCIT prescriptions and 1% of SLIT prescriptions came from allergologists (P < .001). SCIT was more frequently prescribed for GP allergy, whereas SLIT was more frequently
Discussion
The main conclusion from this study is that real-life persistence and compliance with immunotherapy for the most commonly treated allergens in The Netherlands is low. Median treatment duration is far less than the 3 years that are recommended to achieve long-term health benefits. Even the persistent patients, who do reach at least 3 years of treatment, frequently have late pharmacy visits. Persistence and compliance were better in SCIT users than in SLIT users, in patients treated by general
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Supported by the Dutch Medical and health research council (ZonMW; grant 170995002).
Disclosure of potential conflict of interest: E. Röder has received research support from ZonMw (NWO), and her thesis was financially supported by ALK-Abelló, GlaxoSmithKline, HAL, Meda Pharma, Novartis, Phadia, and Stallergenes. R. Gerth van Wijk has received consultancy fees from Allergopharma, has received research support from ZonMw (NWO), and has participated in European Academy of Allergology and Clinical Immunology immunotherapy task forces. The rest of the authors declare they have no relevant conflicts of interest.