Patient preference in allergen immunotherapy - Understanding the patient's view

Allergen Immunotherapy (AIT) is an effective treatment for patients with pollen, house dust mite, or venom allergy, but treatment adherence can be challenging. Patient preferences play a crucial role in acceptance and adherence to AIT, but little is known about these preferences. This study aimed to understand patient preferences for AIT and how these preferences influence treatment acceptance.

A conjoint analysis was conducted among 750 participants from 7 European countries who were allergic to pollen (n = 700) or Hymenoptera venom (n = 50) and had not previously received AIT. Participants were asked to choose between hypothetical AIT products with different attributes, including product type, initial up-dosing posology, potential future risks, and side effects. The relative importance of each attribute was calculated, and sensitivity analyses were performed to assess the impact of specific attribute levels on patient preference.

Potential future risk is the attribute with the strongest impact on the importance score for patient preference in both pollen (44%) and venom (41%) allergic patients, followed by side effects (24% for pollen and 35% for venom allergy). Product type was less important, with a 22% importance score in both populations, and dosing schedules were not important at all, with a 2% importance score for pollen and an 11% importance score for venom-allergic patients. Accumulation of foreign material/substance in the body had the largest negative impact on patient preference, with drops of -24.7% (pollen) and -23.6% (venom), respectively.

Understanding patient preferences is essential for optimizing the design and delivery of AIT. Different side effects and risk profiles of AIT products can influence patient treatment acceptance the most, and healthcare professionals may not always be aware of it. Future research should focus on developing AIT products that align with patient preferences with simultaneously very high effectiveness to improve adherence and treatment outcomes.