title: Adherence to imported fire ant subcutaneous immunotherapy.
abstract: BACKGROUND
  Imported fire ant (IFA) subcutaneous immunotherapy (SCIT) is safe and effective. For optimal protection, SCIT is given monthly for 3 to 5 years. Successful outcomes require patient adherence.
  
  
  OBJECTIVE
  To evaluate SCIT adherence in IFA allergic patients in an endemic area.
  
  
  METHODS
  Patients with systemic reactions to an IFA sting, with detectable specific IgE, who received a recommendation to start IFA SCIT were included. Initial reaction severity and demographic data were collected. Patients were contacted at 1 year regarding interval reactions to stings, SCIT adherence, and reason for nonadherence. Adherence rates were analyzed for association with age, sex, and severity of initial reaction.
  
  
  RESULTS
  Seventy-six patients were enrolled, and 71% adhered to the recommendation to start IFA SCIT. Subgroup analysis did not find significant differences. At 1 year, 97% completed follow-up for analysis, and only 35% remained adherent. Subgroup analysis did not find significant differences. Inconvenience and fear were reported as reasons for not following the recommendation to start or continue with IFA SCIT.
  
  
  CONCLUSIONS
  IFA SCIT is a life-saving therapy that is safe and effective. Despite this, only 71% followed the recommendation to start, and at 1 year only 35% remained adherent. Adherence was not statistically related to age, sex, or severity of initial reaction. Logistical constraints and fear were significant impediments.
authors.affiliation: Division of Allergy and Immunology, Department of Medicine, Wilford Hall Medical Center, San Antonio, TX 78236, USA. shayne.stokes@us.af.mil
authors.forename: Shayne C
authors.initials: SC
authors.lastname: Stokes
authors.forename: James M
authors.initials: JM
authors.lastname: Quinn
authors.forename: Joshua J
authors.initials: JJ
authors.lastname: Sacha
authors.forename: Kevin M
authors.initials: KM
authors.lastname: White
mesh_terms: D000328:Adult; D000485:Allergens / Q000008:administration & dosage* / Q000009:adverse effects / Q000276:immunology; D000818:Animals; D000862:Ant Venoms / Q000276:immunology*; D001000:Ants; D002648:Child; D003888:Desensitization, Immunologic / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006967:Hypersensitivity / Q000628:therapy*; D007073:Immunoglobulin E / Q000097:blood; D007279:Injections, Subcutaneous; D019476:Insect Proteins / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D016896:Treatment Outcome; D016903:Drug Monitoring
chemical_list: D000485:Allergens; D000862:Ant Venoms; D019476:Insect Proteins; D007073:Immunoglobulin E