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Patient dropouts before completion of optimal dose, multiple allergen immunotherapy
1Allergy Section, Midelfort Clinic, Mayo Foundation, Eau Claire, Wisconsin 54701, USA.
Background:
Many patients don't complete the recommended 3 to 5-year course of immunotherapy. Why?
Objective:
Determine the percentage of our patients receiving optimal dose, multiple-allergen immunotherapy from 1982 to 1996 who discontinued their immunotherapy prior to completion of the recommended 3 to 5-year immunotherapy protocol. Second, assess the reasons for these premature dropouts. Third, determine any differences related to the clinic location where injections are given.
Design And Methods:
The medical records of patients who dropped out of our immunotherapy program before 3 years were analyzed by the author.
Summary Of Results:
Our dropout rate before 3 years was 12%. The five commonest reasons for early dropout were concurrent medical problems, noncompliance, change of residence, inconvenience, and allergic reactions. The systemic reaction rate for the 3-year dropout group was 1.00% compared with 0.9% for our overall study group. Eighty-eight percent of the systemic reactions were mild. About 1% of our immunotherapy patients quit early due to allergic reactions secondary to immunotherapy.
Conclusions:
The dropout rate for our optimal-dose patients is similar to/that reported previously by Tinkelman who apparently used a lower than optimal maintenance dose. (2) Many of our dropouts were predictable and avoidable. Few patients quit early due to allergic reactions secondary to our immunotherapy program.