Patient dropouts before completion of optimal dose, multiple allergen immunotherapy.
BACKGROUND
Many patients don't complete the recommended 3 to 5-year course of immunotherapy. Why?


OBJECTIVE
Determine the percentage of our patients receiving optimal dose, multiple-allergen immunotherapy from 1982 to 1996 who discontinued their immunotherapy prior to completion of the recommended 3 to 5-year immunotherapy protocol. Second, assess the reasons for these premature dropouts. Third, determine any differences related to the clinic location where injections are given.


METHODS
The medical records of patients who dropped out of our immunotherapy program before 3 years were analyzed by the author.


RESULTS
Our dropout rate before 3 years was 12%. The five commonest reasons for early dropout were concurrent medical problems, noncompliance, change of residence, inconvenience, and allergic reactions. The systemic reaction rate for the 3-year dropout group was 1.00% compared with 0.9% for our overall study group. Eighty-eight percent of the systemic reactions were mild. About 1% of our immunotherapy patients quit early due to allergic reactions secondary to immunotherapy.


CONCLUSIONS
The dropout rate for our optimal-dose patients is similar to/that reported previously by Tinkelman who apparently used a lower than optimal maintenance dose. (2) Many of our dropouts were predictable and avoidable. Few patients quit early due to allergic reactions secondary to our immunotherapy program.
Rhodes
B J
BJ
Allergy Section, Midelfort Clinic, Mayo Foundation, Eau Claire, Wisconsin 54701, USA.
D000293:Adolescent; D000328:Adult; D000485:Allergens / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D003233:Conjunctivitis, Allergic / Q000628:therapy; D003888:Desensitization, Immunologic / Q000009:adverse effects / Q000191:economics / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007341:Insurance; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010349:Patient Compliance; D010352:Patient Dropouts / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D012130:Respiratory Hypersensitivity / Q000628:therapy; D012189:Retrospective Studies
D000485:Allergens