title: Costs of treatment affect compliance to specific subcutaneous immunotherapy.
abstract: BACKGROUND
  Specific subcutaneous immunotherapy (SCIT) is cost-effective; however its economical burden can lead to non-adherence. We aimed to identify the reported reasons, patient's personal or socio-demographic characteristics and SCIT-related factors associated with non-adherence to SCIT.
  
  
  METHODS
  This is a cross-sectional, observational study held in a Portuguese University Hospital. All records from patients starting SCIT in the last 4 years were reviewed in July 2011. Those without registry of SCIT administration in the previous 3 months were included (n = 181). A telephonic survey was performed and 56 were confirmed as non-adherent; reasons for discontinuation were assessed. Univariate and multiple logistic regression models were developed using characteristics previously described as being associated with non-adhesion.
  
  
  RESULTS
  Economical burden of SCIT was the most important factor leading to treatment discontinuation (40%). In the univariate analysis, presence of family history of allergic disease treated with immunotherapy was associated with decreased OR of non-adherence to SCIT (OR [95%CI] = 0.31 [0.11- 0.88]). In the multiple logistic regression model, none of the factors was significantly associated with non-adherence.
  
  
  CONCLUSIONS
  Adherence is influenced by economic factors. More attention should be given to the impact of economic changes in allergic patient's treatment.
authors.forename: D
authors.initials: D
authors.lastname: Silva
authors.forename: A
authors.initials: A
authors.lastname: Pereira
authors.forename: N
authors.initials: N
authors.lastname: Santos
authors.affiliation: Serviço de Imunoalergologia, Centro Hospitalar São João, E.P.E., Porto, Portugal.
authors.forename: J L
authors.initials: JL
authors.lastname: Plácido
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003888:Desensitization, Immunologic / Q000191:economics / Q000379:methods*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007279:Injections, Subcutaneous; D016015:Logistic Models; D008297:Male; D010349:Patient Compliance
keywords: Allergen Immunotherapy; cost-effectiveness; economical factors; patient compliance; subcutaneous immunotherapy