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Olmastroni E, Galimberti F, Tragni E, Catapano AL, Casula M. Impact of COVID-19 Pandemic on Adherence to Chronic Therapies: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3825. [PMID: 36900831 PMCID: PMC10001666 DOI: 10.3390/ijerph20053825] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/17/2023] [Accepted: 02/19/2023] [Indexed: 06/18/2023]
Abstract
The spread of the coronavirus disease 2019 (COVID-19) pandemic caused a sudden and significant disruption in healthcare services, especially for patients suffering from chronic diseases. We aimed at evaluating the impact of the pandemic on adherence to chronic therapies through a systematic review of available studies. PubMed, EMBASE, and Web of Science were searched since inception to June 2022. Inclusion criteria were: (1) observational studies or surveys; (2) studies on patients with chronic diseases; (3) reporting the effects of COVID-19 pandemic on adherence to chronic pharmacological treatment, as a comparison of adherence during the pandemic period vs. pre-pandemic period (primary outcome) or as rate of treatment discontinuation/delay specifically due to factors linked to COVID-19 (secondary outcome). Findings from 12 (primary outcome) and 24 (secondary outcome) studies showed that many chronic treatments were interrupted or affected by a reduced adherence in the pandemic period, and that fear of infection, difficulty in reaching physicians or healthcare facilities, and unavailability of medication were often reported as reasons for discontinuation or modification of chronic therapies. For other therapies where the patient was not required to attend the clinic, continuity of treatment was sometimes ensured through the use of telemedicine, and the adherence was guaranteed with drug stockpiling. While the effects of the possible worsening of chronic disease management need to be monitored over time, positive strategies should be acknowledged, such as the implementation of e-health tools and the expanded role of community pharmacists, and may play an important role in preserving continuity of care for people with chronic diseases.
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Affiliation(s)
- Elena Olmastroni
- Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, University of Milan, 20133 Milan, Italy
| | | | - Elena Tragni
- Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, University of Milan, 20133 Milan, Italy
| | - Alberico L. Catapano
- Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, University of Milan, 20133 Milan, Italy
- IRCCS MultiMedica, 20099 Sesto San Giovanni (MI), Italy
| | - Manuela Casula
- Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, University of Milan, 20133 Milan, Italy
- IRCCS MultiMedica, 20099 Sesto San Giovanni (MI), Italy
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Xu Y, Guan K. Real‐life data on inactivated COVID‐19 vaccination in patients with subcutaneous allergen immunotherapy. Clin Transl Allergy 2022; 12:e12115. [PMID: 35079348 PMCID: PMC8771587 DOI: 10.1002/clt2.12115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Yingyang Xu
- Department of Allergy, Peking Union Medical College Hospital Chinese Academy of Medical Sciences & Peking Union Medical College Beijing China
- Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment on Allergic Diseases Beijing China
- National Clinical Research Center for Dermatologic and Immunologic Diseases Beijing China
| | - Kai Guan
- Department of Allergy, Peking Union Medical College Hospital Chinese Academy of Medical Sciences & Peking Union Medical College Beijing China
- Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment on Allergic Diseases Beijing China
- National Clinical Research Center for Dermatologic and Immunologic Diseases Beijing China
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Erkoç M, Öztürk BÖ, Mungan D, Öztuna D, Bavbek S, Demirel YS, Aydın Ö, Sin BA. Allergen-specific immunotherapy practices and course of coronavirus disease 2019 (COVID-19) in patients during COVID-19. Asia Pac Allergy 2022; 12:e6. [PMID: 35174057 PMCID: PMC8819422 DOI: 10.5415/apallergy.2022.12.e6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 01/18/2022] [Indexed: 11/04/2022] Open
Affiliation(s)
- Merve Erkoç
- Division of Immunology and Allergy, Department of Chest Diseases, School of Medicine, Ankara University, Ankara, Turkey
| | - Betül Özdel Öztürk
- Division of Immunology and Allergy, Department of Chest Diseases, School of Medicine, Ankara University, Ankara, Turkey
| | - Dilşad Mungan
- Division of Immunology and Allergy, Department of Chest Diseases, School of Medicine, Ankara University, Ankara, Turkey
| | - Derya Öztuna
- Department of Biostatistics, School of Medicine, Ankara University, Ankara, Turkey
| | - Sevim Bavbek
- Division of Immunology and Allergy, Department of Chest Diseases, School of Medicine, Ankara University, Ankara, Turkey
| | - Yavuz Selim Demirel
- Division of Immunology and Allergy, Department of Chest Diseases, School of Medicine, Ankara University, Ankara, Turkey
| | - Ömür Aydın
- Division of Immunology and Allergy, Department of Chest Diseases, School of Medicine, Ankara University, Ankara, Turkey
| | - Betül Ayşe Sin
- Division of Immunology and Allergy, Department of Chest Diseases, School of Medicine, Ankara University, Ankara, Turkey
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Cekic S, Karali Z, Cicek F, Canitez Y, Sapan N. The Impact of the COVID-19 Pandemic in Adolescents with Asthma. J Korean Med Sci 2021; 36:e339. [PMID: 34931499 PMCID: PMC8688346 DOI: 10.3346/jkms.2021.36.e339] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 11/17/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic is affecting people at any age and there is limited information about the effect of the COVID-19 pandemic on quality of life (QoL) in adolescents with asthma. In the present study, it was aimed to assess the attitudes of adolescents with asthma toward the COVID-19 pandemic and determine the effects of the pandemic on their QoL. METHODS In total, 125 adolescents with asthma and 98 healthy adolescents participated in the present study. The questionnaire form consisted of three parts. In the first part, all the participants were asked whether they complied with the protective measures against COVID-19. The second part included questions for measuring the participants' level of concern about COVID-19, while the third part consisted of EUROHIS-QOL 8. RESULTS The patient and control groups were similar in terms of the female/male ratio (55/70 and 48/50, respectively) and mean participant age (14.6 ± 2 and 15.1 ± 1.65 years, respectively) (P = 0.459 and P = 0.062, respectively). The prevalence of COVID-19 in the patients (n = 2, 1.6%) was lower than that in the controls (n = 6, 6.1%); however, the difference was not statistically significant (P = 0.142). The total EUROHIS-QOL score was significantly lower in the patients (31.2 ± 6.7) than in the controls (33.7 ± 4.4) (P < 0.001). The total QoL scores of asthmatic adolescents without other allergic disease (31.4 ± 6.7) was also lower than those of the controls (33.7 ± 4.4) (P = 0.009). Treatment disruption was significantly more common in patients who received subcutaneous immunotherapy (n = 20, 48.8%) than in those who did not (n = 8, 9.5%) (P < 0.001). Moreover, the patients had lower EUROHIS-QOL scores in the overall QoL, general health, finance, and home domains. CONCLUSION Our results indicate that the mean QoL score of asthmatic adolescents during COVID-19 pandemic is lower than in the healthy population. Disruption in their treatment was most common in patients with asthma who were receiving subcutaneous immunotherapy.
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Affiliation(s)
- Sukru Cekic
- Division of Pediatric Allergy, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Zuhal Karali
- Division of Pediatric Allergy, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Fatih Cicek
- Division of Pediatric Allergy, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Yakup Canitez
- Division of Pediatric Allergy, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Nihat Sapan
- Division of Pediatric Allergy, Uludag University Faculty of Medicine, Bursa, Turkey.
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Masieri S, Bachert C, Ojeda P, Kim CK, Carlo C, Giorgio C. Allergen Immunotherapy management during vaccinations: An international survey. World Allergy Organ J 2021; 14:100601. [PMID: 34777679 PMCID: PMC8575483 DOI: 10.1016/j.waojou.2021.100601] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 09/20/2021] [Accepted: 09/29/2021] [Indexed: 11/04/2022] Open
Abstract
Vaccination against viral and bacterial pathogens represents a challenging issue in allergic subjects, mainly concerning patients undergoing allergen immunotherapy (AIT). For this reason, an international survey has been performed involving a panel of experts who responded to a series of questions, also concerning the COVID-19 impact on allergen immunotherapy and vaccinations. The results showed that co-administration of vaccines and AIT requires caution, mainly during the pandemic era. Moreover, the choice of AIT product should be oriented considering also the safety profile.
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Affiliation(s)
- Simonetta Masieri
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | - Claus Bachert
- Upper Airways Research Laboratory and Department of Oto-Rhino-Laryngology, Ghent University, Ghent, Belgium.,Division of ENT Diseases, CLINTEC, Karolinska Institute, University of Stockholm, Stockholm, Sweden.,First Affiliated Hospital, Sun Yat-sen University, International Airway Research Center, Guangzhou, China
| | - Pedro Ojeda
- Asthma and Allergy Clinic Drs. Ojeda, Madrid, Spain
| | - Chang-Keun Kim
- Asthma and Allergy Center, Inje University-Sanggye Paik Hospital, Seoul, South Korea
| | - Cavaliere Carlo
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Ciprandi Giorgio
- Allergy Clinic, Department of Outpatients, Casa di Cura Villa Montallegro, Genoa, Italy
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Koca Kalkan I, Ates H, Aksu K, Yesilkaya S, Topel M, Cuhadar Ercelebi D, Turkyilmaz S, Oncul A, Demir S. Real-life adherence to subcutaneous immunotherapy: What has changed in the era of the COVID-19 pandemic. World Allergy Organ J 2021; 14:100558. [PMID: 34122718 PMCID: PMC8185179 DOI: 10.1016/j.waojou.2021.100558] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/02/2021] [Accepted: 05/25/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Allergen immunotherapy (AIT) must be continued for 3 years, to achieve a long-term modifying effect. Adherence is a key to ensure effectiveness. The objective of this study was, first of all, to evaluate the adherence with subcutaneous immunotherapy (SCIT) and to identify the main causes of SCIT withdrawal in real-life practice in our clinic. Secondly, we also aimed to investigate to what extent the COVID-19 pandemic altered our SCIT receiving patients' treatment adherence behaviors and the factors that affected their decisions. METHODS Retrospective analysis of the medical records of patients ages ≥18 years, who had started SCIT in January 2014 or later until September 2020 in our department for the diagnosis of allergic rhinitis, allergic asthma or venom allergy, were included in the study. Adherence was determined as the accomplishment of 3 years of SCIT. RESULTS A total of 124 patients (72 female [58.1%]; median age, 35 [19-77] years) were included. The adherence rate to SCIT in our tertiary center's real-life setting was 56.25% with a follow-up duration of 3 years before COVID-19 pandemic. Dose modification, defined as reducing patient's planned SCIT dose due to a systemic allergic/large local reaction or missed injection, and its frequency, which is the number of dose adjustments done throughout the SCIT, was found to be the only factor related to nonadherence. But with the pandemic only in 6 months, among 63 patients receiving SCIT, 15 patients (23.81%) dropped out, and the most common reason was fear of being infected with COVID-19 virus during receiving SCIT in hospital (93.33%). The only independent predictor of drop-out during the COVID-19 pandemic was short duration of AIT (p = 0.012). When we compare the dropped-out cases before and after the start of pandemic, AIT duration was significantly shorter in pandemic period (p = 0.005). CONCLUSION Adherence rate to SCIT in our real-world setting study was 56.25% before the COVID-19 pandemic. Our results indicated that patients requiring dose modification were more prone to be non-adherent. Approximately one quarter of patients dropped-out with the start of pandemic, almost all due to fear of being infected during receiving SCIT in hospital. Since short SCIT follow-up time was found to be the only risk factor for drop-out during the COVID-19 pandemic, we believe that patients who are in the early phases of their treatment should be observed more closely and their concerns should be answered by their doctors.
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Affiliation(s)
- Ilkay Koca Kalkan
- Department of Allergy and Clinical Immunology, University of Health Sciences, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Hale Ates
- Department of Allergy and Clinical Immunology, University of Health Sciences, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Kurtulus Aksu
- Department of Allergy and Clinical Immunology, University of Health Sciences, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Selma Yesilkaya
- Department of Allergy and Clinical Immunology, University of Health Sciences, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Musa Topel
- Department of Allergy and Clinical Immunology, University of Health Sciences, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Dilek Cuhadar Ercelebi
- Department of Allergy and Clinical Immunology, University of Health Sciences, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Suleyman Turkyilmaz
- Department of Allergy and Clinical Immunology, University of Health Sciences, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Ali Oncul
- Department of Allergy and Clinical Immunology, University of Health Sciences, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Senay Demir
- Department of Allergy and Clinical Immunology, University of Health Sciences, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
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