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Determinants of patient compliance in allergic rhinoconjunctivitis

Köberlein, Juliane; Kothe, Anna C; Schaffert, Corinna

Current Opinion in Allergy and Clinical Immunology: June 2011 - Volume 11 - Issue 3 - p 192–199
doi: 10.1097/ACI.0b013e3283466fcb
Outcome measures: Edited by Henry Milgrom and Ralph Mösges

Purpose of review Noncompliance to the prescribed therapeutic regimen is a worldwide problem, especially for diseases in which symptoms can vary with different patient factors and with seasons. The consequences are poor health outcomes, progression of disease and increased healthcare costs. Reviews conducted across countries and addressing different diseases are consistent in estimating noncompliance between 30 and 50%. To implement strategies and interventions that enhance compliance, a comprehensive analysis of its determinants is essential.

Recent findings Lack of efficacy was reported as the number one reason for discontinuing the intake of medications prescribed for nasal allergies. Studies on glucocorticosteroids, allergen-specific immunotherapy and antihistamines highlighted the importance of patient education, demographic factors, duration of therapy, side-effects and treatment costs, as well as minor details, such as taste and odour, in improving compliance.

Summary The variation in the methodologies used and the durations of treatments assessed in current compliance research in the field of allergic rhinoconjunctivitis decreases the comparability of results. Therefore, a clear definition of compliance measured in clinical trials with allergic rhinoconjunctivitis sufferers is needed. Moreover, a gold standard for measuring and reporting compliance should be determined to enable better interstudy comparability of the rates and determinants of compliance.

aDepartment of Health Economics and Healthcare Management, Schumpeter School of Business and Economics, University of Wuppertal, Wuppertal, Germany

bInstitute of Medical Statistics, Informatics and Epidemiology (IMSIE), University of Cologne, Cologne, Germany

Correspondence to Juliane Köberlein, PhD, Department of Health Economics and Healthcare, Schumpeter School of Business and Economics Management, University of Wuppertal, Rainer-Gruenter-Str. 21, 42119 Wuppertal, Germany Tel: +49 202 439 1381; fax: +49 202 439 1384; e-mail:

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