Quality of life in insect venom allergic patients

As re-sting rates and mortality in Hymenoptera allergy are generally low, health related quality of life is an important therapeutic target in the treatment of allergic patients. This review focuses on the impact of anaphylactic reactions and the effect of interventions in health related quality of life for Hymenoptera allergic patients.

Anaphylactic reactions following insect stings can have a great impact on the quality of life of insect sting allergic patients. Venom immunotherapy, with information about the risks and benefits of the treatment, was shown to improve health related quality of life. There were no patients whose health related quality of life was so severely impaired that they did not improve with venom immunotherapy. Treatment with an Epipen (ALK-Abello, Nieuwegein, The Netherlands) resulted in a deterioration in health related quality of life.

These findings suggest that patient education of these risks and benefits is as important as the treatment itself in order to achieve all the important therapeutic goals of venom immunotherapy. For most patients the Epipen is insufficient as definitive treatment from a quality of life point of view. Although the low mortality, morbidity and re-sting frequency in Hymenoptera allergic patients has led some authorities to conclude that many patients are treated unnecessarily, this conclusion is refuted by the fact that venom immunotherapy improves health related quality of life in the vast majority of patients receiving this treatment, even if they are not re-stung.