The evaluation of symptom, medication and quality of life scores
Symptom scores with both the total symptom score-6 (TSS-6) and the visual analogue scale (VAS)8,9, and QoL with VAS2,9 are applied to all patients before the initiation of immunotherapy and in every six months until the end of the therapy as part of a routine clinical practice at the study centres. The TSS-6 was assessed by the sum of six symptoms related to nasal, ocular, ear and/or palate with ratings for each symptom ranging from 0 to 3 with a total possible score from 0 (absence of symptoms) to 18 (very severe)2,9. VAS-symptom scores ranged from ’nasal symptoms, not at all bothersome’ (0 cm) to ”nasal symptoms, extremely bothersome’ (10 cm)9. The QoL scores were measured with VAS which ranged from intolerable bothersome’ (0 cm) to ’not at all bothersome’ (10 cm). The patients were instructed to use rescue medication as a stepwise regiment by stepping it up when symptoms were not sufficiently alleviated. The medication score (MS) from the study by Gelincik et al. was used and defined according to the steps, with a range from 0 to 6 shown in supplementary Table 12. MSs in the pre-pandemic period were determined from the data in the medical charts whereas MSs during the pandemic were assessed at the last injection visit.