Satisfaction, Qol and adherence of patients allergic to dust mites and/or pollens undergoing sublingual immunotherapy.

Garrido-Fernández S, Fernández DG, López GS, Mar Escribano Rodríguez MD, Delgado VM, Iglesias-Souto J, Castro Gómez C, Bòria EV, Hernández-Peña J, Sánchez-López J. Immunotherapy. 2024 Jun 18:1-12. doi: 10.1080/1750743X.2024.2347828.

Abstract

Aim: Sublingual immunotherapy (SLIT) changes history of allergic respiratory disease (ARD). However, adherence is a barrier for optimal outcomes. Patients & methods: In the QUALI study, 859 patients with house-dust mite (HDM) and/or pollen induced ARD uncontrolled with symptomatic treatment and undergoing SLIT for at least 6 months or including one pre-coseason (pollen) were collected. 

Allergic respiratory disease evolution following
sublingual immunotherapy.

Results & conclusion: SLIT significantly improved allergic rhinoconjunctivitis (ARC) and asthma symptom control, leading to reduced medication, meaningful health-related quality of life gain, improved nasal, ocular and bronchial symptoms and everyday life activities. Patients were highly satisfied and most of them adhered to SLIT, being forgetfulness the main non-adherence motive. SLIT is a quick effective treatment against persistent moderate-to-severe symptoms in ARC and asthma but it should been improve forgetfulness, as non-adherence reason.

Plain language summary

Sublingual immunotherapy (SLIT) has really changed how we deal with allergic respiratory disease. But there's a catch: sticking to the treatment can be tough.

In the QUALI study, we looked at 859 patients dealing with dust mite and/or pollen allergies who were not getting relief from the usual treatments. We put them on SLIT for at least 6 months or during pollen season.

This treatment made a big difference. Symptoms got better, people needed less medication and they felt better in their day-to-day lives. Most patients were happy with the treatment and stuck to it well, but some forgot sometimes.

In short, SLIT works fast and works well for moderate to severe allergies and asthma. But we need to help people remember to stick with it.

Summary points

• QUALI study is the largest multicenter retrospective cross-sectional study in Spain to provide comprehensive short-term real-life data of the impact, quality of life, satisfaction and adherence in the allergen immunotherapy field.
• Nearly half of the sample are children and adolescents, where allergic rhinitis and asthma impacts with a high prevalence.
• The study use complementary tools for a more precise adherence measurement, which is not a frequent practice among previous studies or clinical practice.
• Significant proportion of patients progressed to a greater or even definite symptom control in terms of frequency and severity.
• There was a reduction on the medication use for symptom relief.
• Sublingual immunotherapy treatment led to a meaningful gain in health-related quality of life in terms of an important reduction of nasal, ocular and bronchial symptoms and in derived problems affecting their daily life.
• Patients and investigators were remarkably satisfied.
• Has been reported high adherence rates, being forgetfulness the main motive for non-adherence.
• Practically none of the patients referred adverse events, and these were local and mostly mild.
• A fast onset of action of allergen-specific immunotherapy is linked to adherence in sublingual immunotherapy.

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