Factors affecting compliance with allergen immunotherapy at a military medical center

Allergen immunotherapy (AIT) is a safe and effective treatment for certain allergic disorders; however, noncompliance with therapy is common. We evaluated the compliance rates among groups receiving AIT at a military medical center and identified factors affecting compliance.

The charts of the 381 actively enrolled patients in our AIT program were evaluated for patient compliance. Noncompliant patients were contacted to determine the reason for stopping therapy. Patients were then grouped by diagnosis, age, sex, military status, and schedule of AIT and evaluated for differences.

The overall compliance rate was 77.4%. The most common reasons for noncompliance included inconvenience, precluding medical condition, and adverse systemic reaction. There were no differences in compliance rates by diagnosis or sex. Noncompliant patients were younger than compliant patients, 35.4 years versus 42.4 years (P = 0.001); however, when patients were divided into three age categories (<18, 18 to 45, and >45 years), the youngest and oldest groups were more compliant (P < 0.001). Active-duty members were less compliant than retirees and family members, 65.7% versus 83.1% and 81.4%, respectively (P = 0.004). Patients receiving a conventional schedule of AIT were more compliant than those on a rush schedule, 80.0% versus 48.4% (P < 0.001).

Factors found to affect patient compliance with an AIT regimen at our military medical center include age, military status, and schedule of AIT. The most common reasons for noncompliance included inconvenience, precluding medical conditions, and adverse systemic reactions. Clinicians need to be aware of the factors limiting patient compliance with AIT in an attempt to maximize treatment effectiveness.