Contribution of a Digital Immunotherapy Management System Focusing on Improved Patient Adherence and Clinical Outcomes in House Dust Mite Rush Subcutaneous Immunotherapy Evaluated with a Before-After Design

Xu Y, Gao Y, Long Y, Wang C et al.  Patient Prefer Adherence. 2026 Oct 22;20:641358. doi: 10.2147/PPA.S641358.

Background: Rush subcutaneous immunotherapy (RIT) requires frequent injections, strict treatment intervals, and long-term follow-up. Digital management integrates injection scheduling, reminders, treatment records, and patient-reported follow-up.
Objective: This study aimed to evaluate the association of a digital immunotherapy management system with adherence and clinical outcomes in patients undergoing RIT.

Methods: This single-center retrospective conventional treatment (Before) followed by digital treatment (After) study design was used to evaluate patients who underwent house dust mite (HDM) RIT at a tertiary hospital in China between January 2022 and May 2025. Patients treated before implementation of the digital immunotherapy management system were assigned to the conventional management group (CMG), whereas those treated after implementation were assigned to the digital management group (DMG). Adherence, maintenance therapy completion, pulmonary function, inflammatory and immunological indicators, the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), and the Combined Symptom and Medication Score (CSMS) were compared.

Results: A total of 129 patients were included, 58 in the CMG and 71 in the DMG, with no significant differences in baseline characteristics between the two groups (all P > 0.05). At 1 year, 49 patients in the CMG and 66 patients in the DMG were evaluated. Good on-time injection adherence (72.7% vs 46.9%, P=0.005) and maintenance completion (81.8% vs 61.2%, P=0.014) were higher in the DMG. The DMG had higher forced expiratory volume in 1 second (FEV1; P=0.037) and forced vital capacity (FVC; P=0.035), and lower RQLQ (P< 0.001) and CSMS (P=0.013) scores. Digital management was associated with maintenance completion (adjusted OR=4.628, 95% CI 1.099– 19.486; P=0.037).
Conclusion: Digital management was associated with better injection adherence, maintenance completion, and selected clinical outcomes, while inflammatory and immunological findings require cautious interpretation. Digital management may help patients maintain regular injections and complete maintenance therapy during long-term RIT. Temporal confounding limits causal inference; prospective multicenter studies are needed.

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