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.