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

Allergy. 2013 Sep;68(9):1193-5. doi: 10.1111/all.12198. Epub 2013 Aug 6.

Abstract

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 < 0.001). An adequate education and a strict follow-up can significantly reduce SLIT's discontinuations.

Keywords: adherence; discontinuation; follow-up; sublingual immunotherapy.

MeSH terms

  • Adolescent
  • Adult
  • Asthma / immunology
  • Asthma / therapy
  • Child
  • Child, Preschool
  • Desensitization, Immunologic
  • Female
  • Humans
  • Male
  • Medication Adherence*
  • Middle Aged
  • Rhinitis, Allergic, Seasonal / immunology
  • Rhinitis, Allergic, Seasonal / therapy
  • Sublingual Immunotherapy* / adverse effects
  • Young Adult