Factors influencing the prescription of allergen immunotherapy: The Allergen Immunotherapy Decision Analysis (AIDA) study

Franco Frati, C. Incorvaia, G. Cadario, A. Fiocchi, G. E. Senna, O. Rossi, A. Romano, E. Scala, C. Romano, A. Ingrassia, M. Zambito, I. Dell'Albani, S. Scurati, G. Passalacqua, G. W. Canonica, Allegretti Lucrezia, Allegrucci Augusto, Altomonte Giorgia, Arena Antonino, Aresu TizianaAriano Renato, Asero Riccardo, Barile Ruggiero, Barresi Lorenzo, Beltrami Valerio, Bernardi Maria Livia, Berra Daniele, Bignardi Donatella, Boccafogli Arrigo, Bonadonna Patrizia, Bonazza Lucio, Borghesan Franco, Buonomo Alessandro, Caboni Silvia, Caminati Marco, Caminiti Daria Maria, Candi Paolo, Cannata Enzo, Cantone Renato, Capuzzimati Laura, Carbonara Annamaria, Caringi Mario, Caruso Cristiano, Casotto Stefano, Castella Vincenzo, Castellano Francesco, Castiglioni Gloria, Catelli Luca, Cavalli Maurizia, Chieco Bianchi Fulvia, Cicuto Giannino, Cilia Marcello, Ciprandi Giorgio, Colangelo Caterina, Colombo Giselda, Coniglio Giovanni, Conte Mariaelisabetta, Contiguglia Rosario, Corica Antonio, Cosentino Cristina, Cremonte Luigi, Crescioli Stefano, Crimi Nunzio, Crosti Francesca, Cutro' Salvatore, Dagnello Mariangela, Damiani Elisabetta, De Marco Antonino, Di Marzo Maurizio, Donini Massimo, Iemoli Enrico, Fancello Paolo, Fassio Filippo, Favero Elisabetta, Feliziani Annamaria, Fenini Maria Giulia, Ferrari Angelo Salvatore, Ferrarini Ettore, Ferrario Enrico, Focarelli Barone Vittorio, Folletti Ilenia, Franchini Maurizio, Fuiano Nicola, Fusi Alessandra, Galati Pietro, Gammeri Enrico, Gani Federica, Gargano Domenico, Gasparini Alberto, Giro Giuseppina, Graziani Antonio, Gregori Maurizio, Grossi Oriano, Guida Giuseppe, Iorno Maria Loredana, La Grutta Stefania, La Rosa Luigi, Landi Massimo, Lattuada Giovanni, Laudani Erasmo, Muratore Lionello, Loporto Gianbruno, Lo Schiavo Mario, Loconte Filomena, Lombardi Carlo, Lombardo Carla, Macaluso Salvatore, Marcer Guido, Marcotulli Maria Cinzia, Mariani Mauro, Marino Nicolò, Marsico Pietro, Melchiorre Antonietta, Melis Andrea, Menzella Francesco, Milanese Manlio, Milani Stefania Francesca Elisabetta, Millarelli Stefano, Minale Paola, Minchella Enrico, Mondino Michela, Morale Aldo Domenico, Morandi Paolo, Musumeci Sonia Nunzialfina, Nardi Gilda, Natoli Rosalba, Nebiolo Franco, Nenna Saverio, Nettis Eustachio, Nico Andrea, Niniano Rosanna, Orlando Maria Rosa, Padua Vincenzo, Paladini Antonio, Parma Maddalena, Pastore Angela, Patella Vincenzo, Pecora Valentina, Pennisi Alfio, Peroni Diego, Peveri Silvia, Pintaldi Lejla, Pinter Elena, Pirrotta Lia, Piscioneri Sandra, Pozzan Sandra Marcella, Pravettoni Valerio, Puddu Enrico, Pugliese Salvatore, Quercia Oliviero, Ragno Claudio, Ragno Vanda, Ramondo Stefania, Reccardini Federico, Ridolo Erminia, Rinaldi Sandro, Rogkako Anthi, Rossi Renato, Rumi Gabriele, Salvati Gaetano, Sanci Sebastiano, Savi Eleonora, Scala Guglielmo, Scarpa Sergio, Schiappoli Michele, Schiavino Domenico, Schirru Maria Antonietta, Sereni Silvia, Serra Paolo, Serravillo Maria, Severino Maurizio, Sforza Michele, Sichili Stefania, Sillano Valeria, Spagna Virgilio, Spina Francesca, Sugamiele Mario, Tarantini Francesco, Tarantino Rosalia, Termini Cinzia, Testi Sergio, Tomsic Mirela, Torlasco Maurizio, Triggiani Michele, Tripodi Salvatore, Turatello Franca, Turchini Stefano, Vaccari Laura, Valenti Giuseppe, Verna Nicola, Vicentini Licia, Vinay Claudio, Viola Marinella, Voltolini Susanna, Zancanaro Andrea, Zangari Paola, Zanoni Giovanna, Zisa Giuliana

Research output: Contribution to journalArticlepeer-review

Abstract

The evidence of efficacy of allergen immunotherapy (AIT) for respiratory allergy has been demonstrated by a number of meta-analyses. However, the daily practice of AIT is quite different from controlled trials, facing challenges in terms of selection of patients, practical performance, and, of particular importance, use of allergen extracts of inadequate quality. We here performed a survey, named the Allergen Immunotherapy Decision Analysis (AIDA), to evaluate which criteria are used by specialists to choose a product for sublingual immunotherapy (SLIT) in patients with respiratory allergy. A questionnaire composed of 14 items to be ranked by each participant according to the importance attributed when choosing SLIT products was submitted to 444 Italian specialists. The responses of the 169 (38.1%) physicians, who answered all questions, were analysed. Most of the respondents were allergists (79%), followed by pulmonologists (10.8%), both allergists and pulmonologists (4.8%), and otorhinolaryngologists (3%); 59.8% of the respondents were males and 40.2% were females. The age distribution showed that 89.9% of the respondents were aged between 35 and 64 years. All respondents usually prescribed AIT products in their clinical practice: 31.4% used only SLIT, whereas 69.2% used both subcutaneous and sublingual administration. The rankings, expressed as means, attributed by physicians for each of the 14 items were as follows: level of evidence-based medicine (EBM) validation of efficacy (3.44), level of EBM validation of safety (4.30), standardization of the product (5.37), efficacy based on personal experience (5.82), defined content(s) of the major allergen(s) in micrograms (5.96), scientific evidence for each single allergen (6.17), safety based on personal experience (6.32), ease of administration protocol (8.08), cost and terms of payment (e.g. instalments) (9.17), dose personalization (9.24), patient preference (9.25), ease of product storage (9.93), reimbursement (10.12), and availability of a helpline or on-line assistance from the manufacturer (11.89). These attitudes need to be taken into consideration by regulatory agencies as well as by producers.

Original languageEnglish
Pages (from-to)11-16
Number of pages6
JournalEuropean Annals of Allergy and Clinical Immunology
Volume45
Issue numberS2
Publication statusPublished - 2013

Keywords

  • Allergen immunotherapy
  • Allergen products
  • Decision analysis
  • Respiratory allergy
  • Sublingual immunotherapy

ASJC Scopus subject areas

  • Immunology and Allergy
  • Medicine(all)

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