title: Causes of SLIT discontinuation and strategies to improve the adherence: a pragmatic approach.
abstract: Sublingual immunotherapy (SLIT) is often discontinued, and many patients do not renew the prescription. We evaluated the reasons for discontinuation and set up an educational/follow-up plan to improve the adherence. In a first phase, the adherence at 4 months was directly assessed. Based on those results, an action plan (education, frequent contacts, and strictly scheduled visits) was developed and tested in other patients. A group of matched patients did not undergo the follow-up plan (controls). In the first phase, involving 252 subjects, at 4 months, there were 30% dropouts, mainly due to side-effects. In the second phase, 149 patients underwent education/follow-up and 90 received no intervention. In the first group, discontinuations at 4 months were 5%, vs 18% in the controls (P = 0.01). After one year, 12% of patients were lost in the first group and 35% in the control group (P < 0.001). An adequate education and a strict follow-up can significantly reduce SLIT's discontinuations.
authors.affiliation: Allergy Unit, G. da Saliceto Hospital, Piacenza, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Savi
authors.forename: S
authors.initials: S
authors.lastname: Peveri
authors.forename: G
authors.initials: G
authors.lastname: Senna
authors.forename: G
authors.initials: G
authors.lastname: Passalacqua
mesh_terms: D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000276:immunology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D003888:Desensitization, Immunologic; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D006255:Rhinitis, Allergic, Seasonal / Q000276:immunology / Q000628:therapy; D063729:Sublingual Immunotherapy / Q000009:adverse effects; D055815:Young Adult
keywords: adherence; discontinuation; follow-up; sublingual immunotherapy