Justicia J.L.,Stallergenes Iberica |
Baro E.,D Health Research |
Cardona V.,Hospital Vall DHebron |
Guardia P.,Hospital Virgen Macarena |
And 4 more authors.
Patient Preference and Adherence | Year: 2011
Background: Allergen-specific immunotherapy (SIT) is a treatment capable of modifying the natural course of allergy, so ensuring good adherence to SIT is fundamental. Up until now there has not existed an instrument specifically developed to measure patient satisfaction with SIT, although its assessment could help us to comprehend better and improve treatment adherence and effectiveness. The aim of this study was to develop an instrument to measure adult patient satisfaction with SIT. Methods: Items were generated from a literature review, focus groups with allergic adult patients undergoing SIT, and a meeting with experts. Potential items were administered to allergic patients undergoing SIT in an observational, cross-sectional, multicenter study. Item reduction was based on quantitative and qualitative criteria. A preliminary assessment of feasibility, reliability, and validity of the retained items was performed. Results: An initial pool of 70 items was administered to 257 patients undergoing SIT. Fifty- four items were eliminated resulting in a provisional instrument with 16 items. Factor analysis yielded four factors that were identified as perceived efficacy, activities and environment, cost-benefit balance, and overall satisfaction, explaining 74.8% of variance. Ceiling and floor effects were negligible for overall score. Overall score was associated with the type and intensity of symptoms. Conclusion: This is the first attempt to develop a satisfaction with SIT measure from the perspective of the allergic patient, and evidence has been found in favor of its reliability and validity. © 2011 Justícia et al, publisher and licensee Dove Medical Press Ltd.
Ojeda P.,Clinica de Asma y Alergia Dres. Ojeda |
de Burgoa V.S.,Pfizer
Journal of Investigational Allergology and Clinical Immunology | Year: 2013
Background: Asthma is associated with high indirect costs due to lower work productivity and higher absenteeism and presenteeism. Objectives: To study loss of productivity measured using the lost workday equivalent (LWDE) index and health care utilization in asthmatics depending on age, geographical location, time period, severity, and level of asthma control. Patients and Methods: In this cross-sectional, observational, epidemiological multicenter study, 120 allergists nationwide were asked to select asthmatic patients aged 18 to 65 years who were evenly distributed according to the 4 levels of asthma severity (Global Initiative on Asthma) during 3 different seasons. The participants collected sociodemographic data, spirometry values, Asthma Control Test (ACT) score, health care utilization data, perceived stress according to the Impact on Work Productivity Index (IMPALA, Índice del Impacto de la Enfermedad en la Productividad Laboral), and score on the Sheehan disability scale. The LWDE index was used to measure the number of workdays lost and the number of workdays with asthma symptoms combined with the percentage for average performance at work. Results: The study sample comprised 1098 patients (58.7% females; 48.5% aged 18-40 and 51.5% aged 41-65). According to the ACT score, disease was uncontrolled in 57.6% of patients, well controlled in 32.8%, and totally controlled in 9.6%. The mean cost due to workdays lost was €285.81/patient/mo (95%CI, €252.71-318.92). Indirect costs were significantly higher in older patients (41-65 years, €405.08; 95%CI, 348.97-461.19), patients with more severe disease (€698.95; 95%CI, €588.63-809.27), and patients with more poorly controlled asthma (€466.86; 95%CI, €414.39-519.33). The average cost of health care units per patient for each 3-month period was €1317.30 (95%CI, €1151.34-€1483.26). Indirect costs were significantly higher in older patients (€2104.00 in patients aged 18-40 vs €3301.55 in patients aged 41-65), in northern and central regions, in severe disease (€2921.63), and in more poorly controlled asthma (€1799.42). Conclusion: Our findings could prove useful for physicians and health care providers. © 2013 Esmon Publicidad.