ALLERGY PATIENTS TREATED WITH
IMMUNOTHERAPY EXPERIENCE INCREASED
QUALITY OF LIFE AND FEWER SICK DAYS
AFTER ONE YEAR
Authors: Petersen KD§1, Kronborg C2, Beck SJ3, Larsen JN4, Dahl R5,
Gyrd-Hansen D2, 6
§1Corresponding:
Karin Dam Petersen, Danish Centre for Healthcare Improvements,
Aalborg University, Department of Business and Management, Aalborg, Denmark, email: KDP@business.aau.dk. 2Centre of Health Economics Research (COHERE),
University of Southern Denmark. 3Centre for Public Health and Quality Development,
Central Denmark Region. 4Department of Research & development, ALK-Abelló,
Hørsholm.5Department of Respiratory Disease, Aarhus University Hospital. 6Australian
Centre for Economic Research on Health, ACERH, University of Queensland & Health
Economics Research Unit, University of Southern Denmark & The Danish Institute for
Health Services Research, Copenhagen.
Purpose: The purpose of this
study was to assess the effect of
subcutaneous-allergen-specificimmunotherapy (SCIT) on disease
severity classifications, number of
days affected and sick days per year
on patients with grass-pollen and/or
house dust mite (HDM) induced
allergic rhino-conjunctivitis (RC)
and/or asthma (A).
Background:
Approximately one fourth of the adult population in Europe suffer from respiratory
allergy and the prevalence of grass pollen allergy is on average 18%. Interventions against respiratory
allergy include symptomatic treatment, allergen avoidance and allergen specific immunotherapy. SCIT
involves subcutaneous injections with increasing doses of specific allergen vaccine until a maintenance
dose is reached, and at regular intervals for 3-5 years thereafter. Recently three self-rated Health Related
Quality of Life (HRQoL) instruments were used simultaneously to study the baseline HRQoL among 248
Danish allergic RC and/or A patients before start of SCIT with grass pollen and/or HDM. The three
instruments were the disease specific RC Quality of Life Questionnaire (RQLQ) and two generic instruments
(EQ-5D and 15D). All three instruments were able to distinguish HRQoL on a day with allergen exposure
from a day without. This present study is a one year follow-up study of this baseline HRQoL study
Methods: The study was a multi-centre study with prospective follow-up.
Results: After one year the disease severity classifications
Patients (>16 years) were recruited consecutively from 13 clinics specialised in
specific allergy management. An intension to treat approach was applied. The
outcome measures included change in; disease severity (classified by specialist
doctors), RQLQ-scores, number of days with symptoms, number of sick days
from work, change in generic HRQoL and Quality-Adjusted-Life-Years (QALY).
showed significantly improved disease control. Mean RQLQscore was reduced from 3.02 at baseline to 2.00 at follow-up.
Average annual days with symptoms were reduced from 189
days to 145 days whilst annual sick days were reduced from 3.7
to 1.2 days. The 15D-score increased from 0.83 to 0.86 and the
EQ-5D-score from 0.70 to 0.77, which indicated an annual gain
per patient of 0.03-0.06 QALY.
RQLQ, EQ-5D and 15D
measures on a day with allergy
and on a day without allergy
symptoms
EQ-5D profile of the patients Baseline (B) and
Follow-up (F) on a typical day with allergy
60
B
F
B
F
B
F
B
F
40
F
No problems
Extreme problems
Some problems
Missing
20
experience
• significantly increased HRQoL
• 44 days reduction in days with symptoms
• 2.5 days reduction in sick days from work
• 0.03-0.06 QALY’s gained
when treated with SCIT for one year.
B
0
Conclusion: Allergic patients suffering from RC alone or RC and A
propertion of patients
80
100
Figure 2. EQ5D profile of patients (N=210) screened to SCIT on a day with allergy, baseline (B) and followup (F)
B
F
Mobility
Mobility
B
F
Self-care
Self-care
B
F
Usual activities
Usual activities
No problems
No problems
Extreme problems
Extreme
problems
B
F
Pain/disc.
Pain/discomfort
Some
problems
Some or moderate
problems
Missing
missing
B
F
Anxiety/dep.
Anxiety/depression