Study design
This multi-centre study was prospectively conducted on adult allergic
rhinitis (AR) and/or asthmatic patients receiving the maintenance phase
of SCIT with aeroallergens in the coordinating centre of the study, the
adult immunology and allergy clinic at Istanbul Faculty of Medicine and
in three other adult immunology and allergy centres in Istanbul
(Yedikule Chest Diseases and Thoracic Surgery Education and Research
Hospital, Şişli Hamidiye Etfal Education and Research Hospital, Kartal
Dr Lütfi Kırdar Education and Research Hospital).
During the study period of March 15, 2021 and September 15, 2021,
patients’ routine SCIT injection visits were continued under strict
virus transmission prevention measures. All staff members used personal
protective equipments during SCIT application visits to ensure standard
contact and droplet protection1. Wearing a surgical
mask was mandatory for all patients. Sufficient time was left between
each application and interviews to provide ambient ventilation,
necessary preparations and disinfection of materials that might have
been contaminated. As recommended, injection visits were not interrupted
unless the patient and/or his/her contact persons were
infected1.
Treatment interruptions and their reasons were collected through
telephone interviews at the end of August. In addition, the patients’
educational status, professions, transportation options for reaching the
hospital, smoking habits, co-morbid diseases, concomitant drug usage and
concomitant COVID-19 infection, were all questioned.
The patients were allocated into three groups according to SCIT
application periods. The first group consisted of the patients who
received SCIT injections in the recommended routine time interval of one
month. The patients who missed injection doses that resulted in an
interval of <2 months and ≥2 months between subsequent
injections formed the second and third groups,
respectively2. Patients in Group 3 were considered as
non-adherent whereas patients in Group 1 and Group 2 as adherent
according to SCIT adherence studies2. The reasons for
missing doses were questioned and identified. Patients’ demographic
features and clinical diagnostic tests were collected from medical chart
records. The measures of asthma control test (ACT)7,
symptom, medication and quality of life (QoL) scores were applied
routinely on injection visits every six months before the pandemic and
once during the pandemic and were compared among adherent and
non-adherent groups.
Before the study, ethical approval from the ethics committee of Istanbul
Faculty of Medicine (2020/78367) and authorization from The Ministry of
Health for conducting the study (2020-06-04T13_52_49) were obtained.
After the clinical data of each patient were filled in medical charts
and were ready to be used as study documents, patients’ informed consent
forms were collected after the telephone interviews in order not to
influence the real-life findings of the study.