Patients using immunotherapy for allergy report satisfaction with providers

Key takeaways:

• 56% of respondents with respiratory allergies have used immunotherapy.
• 46% of respondents with food allergies have used immunotherapy.
• 85% of respondents with food allergies have at least five allergies.

The use of immunotherapy among patients with multiple allergies and comorbidities not only is prevalent, but it also is linked to higher satisfaction with health care professionals, according to a survey conducted by Health Union.

The researchers behind the inaugural Allergies in America survey also reported that this therapy is associated with more active leveraging of condition management resources among these patients.

“Health Union conducts regular surveys for all 40 of its condition-specific online health communities,” Sara Hayes, vice president of community development at Health Union, told Healio.

Sara Hayes

These surveys are designed to comprehensively span the patient journey, including demographics, diagnosis, symptoms, side effects, relationships with health care providers, treatment experience and quality of life, Hayes continued.

“As such, these surveys provide a comprehensive landscape of the condition experience, from the perspective of the patient and caregivers, depending on the condition,” she said.

The survey design and results

The 85-question survey polled 1,021 adults with allergy between March 30, 2020, and Feb. 16, 2021. It examined the experiences of people living with various allergy types, including respiratory and environment-related allergies, food allergies and latex allergies at a granular level, Hayes said.

The survey found that 56% of respondents with respiratory allergy and 46% of those with food allergy currently use or previously have used immunotherapy.

Nearly two-thirds of respondents with respiratory allergy who have used immunotherapy report at least five different allergies, compared with 41% of those who have not been treated with it. Also, 85% of the respondents with food allergy who have used immunotherapy have at least five allergies, compared with half of those who have not used the treatment.

A greater proportion of both respiratory and food allergy respondents who have used vs. have not used immunotherapy recently experienced allergic rhinitis, cough, fatigue and wheezing or shortness of breath.

Further, more respondents with food allergy who have been vs. have not been treated with immunotherapy experienced anxiety, dizziness, hives, itchiness and swelling.

The survey additionally found that more patients with food or respiratory allergy treated with immunotherapy compared with those not treated were diagnosed with and managing other conditions, primarily asthma, atopic dermatitis, chronic sinusitis and nasal polyps.

Whether they had food or respiratory allergy, a greater proportion of patients treated vs. not treated with immunotherapy reported having seen an allergist, and more treated vs. not treated respiratory allergy respondents reported satisfaction with health provider care and easy-to-understand test results and treatment explanations.

Noting a potential link to the volume of symptoms that patients using immunotherapy have experienced, the researchers said these respondents also have used a wide range of therapies, such as nasal spray and oral, intravenous or topical corticosteroids.

A greater proportion of patients with food or respiratory allergies on vs. not on immunotherapy leveraged a greater number of resources beyond their health care providers to learn about or manage their condition, such as allergy-specific websites, allergy associations and online support groups or patient communities.

Responses from the community

To assist with these issues, Health Union launched allergies.net to provide information, connections and support for people living with a wide range of allergy types, including respiratory, food, medication, insect and latex allergies.

“The findings from the Allergies in America survey specific to immunotherapy were in line with the conversations we’ve observed within the allergies.net community,” Hayes said. “However, there were definitely some other findings that were significant or surprising.”

While 96% of respondents are diagnosed with more than one allergy, Hayes noted, there are varying experiences in terms of treatment. When asked about treatment plans, many participants on allergies.net said they use many different treatments at once to relieve their diverse symptoms.

One member of the allergies.net Facebook page said treatment for environmental allergies involves nasal flushing (Nävage, RhinoSystems) twice a day, two injections every other week, two nasal sprays and cetirizine (Zyrtec, Sandoz).

“The predictable shot helps for a while, but it’s overwhelming,” this poster wrote.

Also, only three in 10 respondents carry epinephrine (EpiPen, Pfizer). One respondent who lives with a serious bee sting allergy said he stopped buying EpiPens as he got older because they were expensive and expired regularly.

“So, he just tries his best to avoid the bees rather than spending money every year for something he may not have to use,” Hayes said.

Immunotherapy treatment, however, has had a positive impact on quality of life, Hayes continued.

“Based on what we’ve seen within the allergies.net community, successful immunotherapy treatment has led to better controlled asthma symptoms for some, as well as reduced symptoms of allergies to specific allergens,” Hayes said.

“This could mean that allergen avoidance/hypervigilance is improved and, as a result, people can participate in more social activities than before immunotherapy treatment,” she continued.

But barriers such as inconvenience remain in accessing this treatment, according to members of the allergies.net community. 

“Receiving allergy shots can be a major time commitment and involve a rigorous schedule because they typically require frequent injections. We’ve also seen community participants mention the inconvenience of having to wait in the allergy clinic or doctor’s office after receiving shots for observation,” Hayes said.

The costs of allergy shots often can be a significant obstacle as well, even with insurance, members of the community reported. Risks for mild to severe reactions during and after immunotherapy represent another hurdle.

And due to the success of allergy immunotherapy often depending on patients’ active participation in the treatment, Hayes continued, low health literacy could interfere with receiving care as well.

Doctors can play a role in improving access to immunotherapy for their patients, but Hayes cautioned that there isn’t any great one-size-fits-all solution.

“Health care professionals will have to work with health systems, social support resources and pharma companies in a variety of ways to improve access,” she said.

Hayes suggested a few areas that could benefit from extra support via partnerships or by doctors working with these entities.

For example, doctors could provide resources that help cover the cost of immunotherapy both with and without insurance, as well as provide resources to support the costs of and access to transportation for this treatment.

Also, Hayes recommend developing solutions for administering treatment that would require less time in the doctor’s office, which would particularly help people who cannot take off from work easily on a regular basis.

“There may be logistical challenges, but doctors could also try to support patients in trying sublingual immunotherapy, so that they can self-administer at home,” Hayes said.

Finally, education is key.

“To combat health literacy concerns, health care providers should continuously work on educating patients on allergic diseases, with a focus on quality of life and health consequences and explaining the benefits and risks of treatment,” Hayes said.

Reference:

• Allergies in America. https://www.dropbox.com/s/pbtq0dql3cb4k41/Allergies%20In%20America%202021%20Findings-For%20PR%20and%20Marketing.pdf?dl=0. Published Aug. 25, 2022. Accessed Aug. 25, 2022.