title: The effect of a new communication template on anticipated willingness to initiate or resume allergen immunotherapy: an internet-based patient survey.
abstract: BACKGROUND
  A patient's knowledge of his/her allergic condition and treatment is a key factor in adherence and effectiveness.
  
  
  METHODS
  To assess patients' understanding of allergy and acceptance of allergen immunotherapy on the basis of (i) information given by their physician at the time of prescription and (ii) a new communication template viewed some months later, we performed an Internet-based survey of patient panels in France, Germany, Spain, the USA and Russia. The survey participants were either recent "early abandoners" (having discontinued allergen immunotherapy before the end of the prescribed course) or "non-starters" (having decided not to initiate a course of allergen immunotherapy recommended by their physician). All participants completed an on-line questionnaire immediately before and immediately after viewing the new communication template. The study's main objectives were to validate the new communication template and to assess its impact on anticipated willingness to initiate or resume allergen immunotherapy.
  
  
  RESULTS
  We surveyed a total of 261 patients (France: 57; Germany: 51; Spain: 52; USA: 51; Russia: 50), comprising 127 "early abandoners" and 134 "non-starters". The mean time since symptom onset and selection for the study was 14.5 years. Subcutaneous allergen immunotherapy had been prescribed in 60 % of cases. Twenty-eight percent of the participants did not know for which allergy they were being treated. Early abandoners reported a perception of low effectiveness (39 %) and complained about expense (39 %) and practical constraints (32 %). Twenty-two percent of the non-starters feared side effects. The communication template was considered to be clear (by 92 % of the patients), convincing (by 75 %) and reassuring (by 89 %); 80 % of the participants felt better informed afterwards, and 67 % stated that viewing the communication template would have made them more likely to continue or initiate allergen immunotherapy (overall willingness score: 5.65 out of 10 before viewing and 7.1 out of 10 afterwards).
  
  
  CONCLUSIONS
  After viewing a new communication template on allergy and allergen immunotherapy, patients participating in the survey felt better informed and more likely to initiate or complete this therapy. It now remains to investigate the communication template's effect on actual acceptance of and adherence to allergen immunotherapy.
authors.affiliation: Section of Allergy and Clinical Immunology, Imperial College London - National Heart & Lung Institute, Royal Brompton Hospital, Dovehouse Street, London, United Kingdom.
authors.forename: Moises A
authors.initials: MA
authors.lastname: Calderon
authors.affiliation: Nova Southeastern University, Davie, FL USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Cox
authors.affiliation: Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL USA.
authors.forename: Thomas B
authors.initials: TB
authors.lastname: Casale
authors.affiliation: Universitätsklinikum Köln, Universität zu Köln, Köln, Germany.
authors.forename: Ralph
authors.initials: R
authors.lastname: Mösges
authors.affiliation: Center for Rhinology and Allergology, Wiesbaden, Germany ; Department of Otorhinolaryngology, Head and Neck Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Pfaar
authors.affiliation: Allergy Clinic, Danish AllergyCenter, Dermato-Allergological Department, Gentofte University Hospital, Copenhagen, Denmark.
authors.forename: Hans-Jørgen
authors.initials: HJ
authors.lastname: Malling
authors.affiliation: Allergy Department, Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: Joaquin
authors.initials: J
authors.lastname: Sastre
authors.affiliation: NRC Institute of Immunology FMBA, Moscow, Russian Federation.
authors.forename: Musa
authors.initials: M
authors.lastname: Khaitov
authors.affiliation: Department of Pulmonology - Division of Allergy, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, France ; Sorbonne Universités, UPMC Paris 06, UMR-S 1136, IPLESP, Equipe EPAR, Paris, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Demoly
keywords: Adherence; Allergen immunotherapy; Allergy; Information; Patient-physician communication