Patient Preference and Adherence (Jul 2023)

Shared Decision-Making in Allergen Immunotherapy (AIT) Options Using a Questionnaire for Respiratory Allergic Patients: A Delphi Consensus Study

  • Antón M,
  • Cabañes N,
  • Fernández-Meléndez S,
  • Fernández-Nieto M,
  • Jiménez-Ferrera G,
  • Letrán A,
  • Méndez-Brea P,
  • Montoro J,
  • Moreno F,
  • Mur-Gimeno P,
  • Rodríguez-Vázquez V,
  • Rosado A,
  • Sánchez-Guerrero I,
  • Vega-Chicote JM,
  • Vidal C

Journal volume & issue
Vol. Volume 17
pp. 1771 – 1782

Abstract

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Mónica Antón,1 Nieves Cabañes,2 Salvador Fernández-Meléndez,3 Mar Fernández-Nieto,4 Gloria Jiménez-Ferrera,5 Antonio Letrán,6 Paula Méndez-Brea,7 Javier Montoro,8,9 Francisco Moreno,6 Pilar Mur-Gimeno,10 Virginia Rodríguez-Vázquez,7 Ana Rosado,11 Inmaculada Sánchez-Guerrero,12 Jose Mª Vega-Chicote,3 Carmen Vidal7,13 1Allergy Department, Hospital Universitario San Juan de Alicante, Alicante, Spain; 2Allergy Department, Hospital Universitario de Toledo, Toledo, Spain; 3Allergy Department, Hospital Civil de Málaga, Malaga, Spain; 4Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain; 5Allergy Department, Hospital Universitario de Badajoz, Badajoz, Spain; 6Allergy Unit, Centro médico Asisa Doctor Lobatón, Cádiz, Spain; 7Allergy Department, Complejo Hospitalario Clínico Universitario de Santiago, Santiago de Compostela, Spain; 8Allergy Department, Hospital de Llíria, Valencia, Spain; 9Department of Medicine, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain; 10Allergy Department, Hospital de Santa Bárbara, Puertollano, Ciudad Real, Spain; 11Allergy Department, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain; 12Allergy Department, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain; 13Department of Medicine, Universidad de Santiago de Compostela, Santiago de Compostela, SpainCorrespondence: Carmen Vidal, Allergy Department, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, 15706, Spain, Tel +34 981 951752, Email [email protected]: The objective of this study was to develop and validate a questionnaire, through a Delphi consensus, to be used by allergists in their routine clinical practice to assess the preferences of patients starting allergen immunotherapy (AIT) treatment using an objective approach.Patients and Methods: A Delphi consensus-driven process was used. The scientific committee, composed of 15 allergists, led the study and participated in the preparation of the questionnaire. Two-hundred panelists from different Spanish regions were invited to complete a 16-item questionnaire on a nine-point Likert scale covering six topic blocks. Consensus was achieved if ≥ 66.6% of panelists reached agreement or disagreement.Results: Of the 200 experts invited to participate in the Delphi process, a total of 195 (97.5%) answered the questionnaire. The panel experts reached a consensus on “agreement” on a total of 12 of the 16 (75.0%) items, covering a total of six categories: (a) patient knowledge (2 questions), (b) barriers to patient adherence (3 questions), (c) patient behavior (4 questions), (d) future actions (3 questions), (e) treatment costs (2 questions), and (f) final patient preferences (2 questions).Conclusion: This Delphi consensus study validated a set of twelve recommended questions for patients objectively assessing their preferences and suitability for the most common AIT options available. The questionnaire intends to assist allergists in making an objective, unconditioned decision regarding the best AIT option for each patient, after informing them about the different routes.Keywords: allergen immunotherapy, Delphi consensus, shared decision-making, questionnaire

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