title: Adherence issues related to sublingual immunotherapy as perceived by allergists.
abstract: OBJECTIVE
  Sublingual immunotherapy (SLIT) is a viable alternative to subcutaneous immunotherapy to treat allergic rhinitis and asthma, and is widely used in clinical practice in many European countries. The clinical efficacy of SLIT has been established in a number of clinical trials and meta-analyses. However, because SLIT is self-administered by patients without medical supervision, the degree of patient adherence with treatment is still a concern. The objective of this study was to evaluate the perception by allergists of issues related to SLIT adherence.
  
  
  METHODS
  We performed a questionnaire-based survey of 296 Italian allergists, based on the adherence issues known from previous studies. The perception of importance of each item was assessed by a VAS scale ranging from 0 to 10.
  
  
  RESULTS
  Patient perception of clinical efficacy was considered the most important factor (ranked 1 by 54% of allergists), followed by the possibility of reimbursement (ranked 1 by 34%), and by the absence of side effects (ranked 1 by 21%). Patient education, regular follow-up, and ease of use of SLIT were ranked first by less than 20% of allergists.
  
  
  CONCLUSIONS
  These findings indicate that clinical efficacy, cost, and side effects are perceived as the major issues influencing patient adherence to SLIT, and that further improvement of adherence is likely to be achieved by improving the patient information provided by prescribers.
authors.affiliation: Scientific and Medical Department, Stallergenes, Milan, Italy;
authors.forename: Silvia
authors.initials: S
authors.lastname: Scurati
authors.forename: Franco
authors.initials: F
authors.lastname: Frati
authors.forename: Gianni
authors.initials: G
authors.lastname: Passalacqua
authors.forename: Paola
authors.initials: P
authors.lastname: Puccinelli
authors.forename: Cecile
authors.initials: C
authors.lastname: Hilaire
authors.forename: Cristoforo
authors.initials: C
authors.lastname: Incorvaia