D3.180 - Good patient adherence to sublingual immunotherapy for allergic rhinitis can be achieved, when ENT-physicians collaborate with pharmacies in a straightforward adherence programme

Adherence decreases with treatment duration; however, 3-years sublingual immunotherapy tablet (SLIT) treatment is essential for optimal allergic rhinitis treatment efficacy. Our goal is to systematically coach and motivate patients to improve adherence and provide patients with the full benefits of SLIT treatment.

The ENT department, the polyclinical pharmacy, and a 40 pharmacies’ network established a SLIT-treatment adherence programme. The physician verified eligibility, prescribed SLIT using a special prescription form, conducted annual review, and 1 reminder call if no show.

The form specifies start, refill frequency (90 days), duration (3 years), and care pathway (discussing with patient the scope, expectations, goals, consent, and initial 30 tablets handout). Subsequently, administration, support needs, follow-up, and handling side effects were addressed.

Pharmacies contacted patients at days 0, ±3, ±90, ±170, ±240, and ±365; thereafter, twice a year.  Definitions: completion is 1000 tablets collected by patient; discontinuation is 91 days late for refill. 

Treatments (n=213) were initiated from 2021 and continued at the polyclinic pharmacy (n=68) or pharmacy network (n=145). Discontinuation occurred due to relocation patient (n=2), discontinuation with programme and treatment (n=45), or only with programme (n=11). Switches of treatment to subcutaneous immunotherapy (n=26) or biologicals (n=2), occurred too. At least 138 (65%) of SLIT treatments and 164 (77%) of immunotherapy treatments were completed. 

Three-year patient adherence rates (77% of patients completed allergen immunotherapy treatment) exceed rates previously reported. This highlights how ENT physicians and pharmacies may collaborate efficiently and improve patient adherence.