Advances in Therapy

, Volume 33, Issue 7, pp 1199–1214 | Cite as

Comprehensive Study of Patients’ Compliance with Sublingual Immunotherapy in House Dust Mite Perennial Allergic Rhinitis

  • Alfonso Malet
  • Angel Azpeitia
  • Diego Gutiérrez
  • Francisco Moreno
  • María del Mar San Miguel Moncín
  • José Angel Cumplido
  • Magdalena Lluch
  • Eva BaróEmail author
  • Albert Roger
Original Research



Allergen immunotherapy is a long-term treatment that has been associated with patient adherence issues. The aim of the study was to increase the knowledge on compliance of patients allergic to house dust mites, receiving sublingual immunotherapy (SLIT).


A retrospective observational study was performed in 53 Spanish allergy units. We enrolled patients undergoing the SLIT treatment for house dust mites including a scheduled control visit 12 months after initiating the therapy. We conducted a comprehensive assessment of compliance using three methods. In the first step, an allergist evaluated the patients according to the results of an interview and the existing medical records. The subjects taking more than 80% of the overall prescription were defined as compliant. The remaining noncompliant patients were divided into groups taking less than 25%, 25–50%, and 50–80% of the prescribed SLIT. In the second stage, we conducted the Morisky–Green test. Finally, the noncompliant patients were asked to fill a self-report assessment form. Data were stratified into age groups. The potential factors affecting compliance were also investigated.


Overall, 380 subjects participated in the study. The compliance rate was 79.7%, and the treatment discontinuation rate was 22.5%, while 66.8% of patients were adherent (both compliant and continuing with the treatment). The results showed that children were the most compliant and adolescents the least compliant (86.6% and 60.9%, respectively). The main reason for noncompliance was “forgetting some doses” in 31.0% of the children, 48.0% of the adolescents, and 53.2% of the adults. Compliance was associated with the following factors: age, number of annual control visits, and reduction in symptomatic medication.


Our results showed that two out of three patients with house dust mite-induced allergic rhinitis adhered to the SLIT treatment. Multidisciplinary and integral solutions are needed to improve the compliance, with special attention paid to adolescents.


Stallergenes Greer Spain.


Allergy Adherence Allergen immunotherapy Pulmonary Respiratory Treatment interruption Sublingual immunotherapy 



Sponsorship and article processing charges for this study were funded by Stallergenes Greer Spain. All named authors meet the International Committee of Medical Journal Editors criteria for authorship for this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval to the version to be published. Editorial assistance in the preparation of this manuscript was provided by Irantzu Izco-Basurko. Support for this assistance was funded by Stallergenes Iberica.


Alfonso Malet, Angel Azpeitia, Diego Gutiérrez, Francisco Moreno, María del Mar San Miguel Moncín, José Angel Cumplido, Magdalena Lluch, Eva Baró, and Albert Roger have nothing to disclose.

Compliance with Ethics Guidelines

All procedures were in accordance with the ethical standards of the responsible committees on human experimentation (institutional and national) and with the Helsinki Declaration of 1964, as revised in 2013. Informed consent was obtained from all patients included in the study.


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Copyright information

© Springer Healthcare 2016

Authors and Affiliations

  • Alfonso Malet
    • 1
  • Angel Azpeitia
    • 2
  • Diego Gutiérrez
    • 3
  • Francisco Moreno
    • 4
  • María del Mar San Miguel Moncín
    • 5
  • José Angel Cumplido
    • 6
  • Magdalena Lluch
    • 1
  • Eva Baró
    • 7
    Email author
  • Albert Roger
    • 8
  1. 1.Al.lergo CentreBarcelonaSpain
  2. 2.Medical DepartmentStallergenes IbericaBarcelonaSpain
  3. 3.Servicio Neumologia-AlergiaPuerta del Mar HospitalCádizSpain
  4. 4.Doctor Lobatón ClinicCádizSpain
  5. 5.Allergy Unit, Pius Hospital de VallsXarxa Santa TeclaTarragonaSpain
  6. 6.Doctor Negrín University HospitalGran CanariaSpain
  7. 7.Health Outcomes Research Department3D HealthBarcelonaSpain
  8. 8.Allergy UnitGermans Trias i Pujol HospitalBadalonaSpain

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