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[Causes of stopping subcutaneous specific immunotherapy in asthmatic children]
Ya-Na Huang1, Ying Huang, Ji-Hong Dai
1Department of Respiratory Disease, Children's Hospital of Chongqing Medical University, Chongqing, China. huangying62@126.com
Insights
Over half of asthmatic children stopped subcutaneous specific immunotherapy (SCIT) due to perceived inefficacy or asthma remission. Improving patient education on SCIT
Area of Science:
- Pediatric Allergy and Immunology
- Respiratory Medicine
- Clinical Therapeutics
Context:
- Subcutaneous specific immunotherapy (SCIT) is a crucial treatment for allergic asthma in children.
- Treatment compliance remains a significant challenge, impacting long-term outcomes.
- Understanding reasons for SCIT discontinuation is vital for optimizing pediatric asthma management.
Purpose:
- To identify and analyze the primary reasons why asthmatic children discontinue subcutaneous specific immunotherapy (SCIT).
- To provide insights for improving patient adherence to SCIT regimens in pediatric asthma care.
Summary:
- A study of 616 asthmatic children revealed that 52.2% stopped SCIT before completing the 3-year course.
- Key reasons for discontinuation included perceived inefficacy (41.8%), asthma remission (22.8%), cost (9.4%), and treatment complexity (7.9%).
- A significant portion (54.3%) stopped SCIT within the first year, highlighting early adherence issues.
Impact:
- Findings underscore the need for enhanced patient and parent education regarding SCIT's long treatment duration and gradual effects.
- Strategies to objectively assess asthma control and proactively manage adverse reactions are crucial for improving SCIT compliance.
- Optimizing SCIT adherence can lead to better long-term asthma control and quality of life for pediatric patients.
Objective:
To improve the compliance with subcutaneous specific immunotherapy (SCIT) by analyzing the causes of stopping SCIT in asthmatic children.
Methods:
A telephone follow-up was conducted in the asthmatic children who received SCIT but did not finished the 3-year course of treatment from June 2005 to October 2010, so as to analyze the causes of stopping SCIT.
Results:
A total of 616 asthmatic children received SCIT, and 322 (52.2%) of them stopped SCIT.A total of 127 cases (39.4%) of the 322 children received telephone follow-up. In the 127 children, 53 (41.8%) stopped the SCIT for the reason of bad effecacy, 29 (22.8%) for remission of asthma,12 (9.4%) for expensive fees, 10 (7.9%) for complex process of treatment, 10 (7.9%) for adverse reaction, 9 (7.1%) for long distance from the hospital, and 4 (3.1%) for having no time for treatment. And 69 (54.3%) of them stopped SCIT in the first year, 28 (22.1%) in the second year, and 30 (23.6%) in the third year. Currently, 85 cases (66.9%) of the 127 asthmatic children were up to the control level, and the other 42 cases were not. There was significant difference in the control level of asthma berween the group receiving treatment with regular inhaled corticosteroids (ICS) and the group receiving treatment with irregular ICS (P<0.01).
Conclusions:
Bad efficacy, remission of asthma, expensive fees, complex process of treatment, and adverse reaction are the main reasons contributing to the stop of SCIT in asthmatic children. To improve the compliance with SCIT, It is important to make the patients and their parents understand the long treatment course and slow effect of SCIT, encourage them to use objective indices for evaluating the state of asthma, and effectively prevent and treat the adverse reactions.
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