ABSTRACT
INTRODUCTION: The patients' acceptance of the treatment scheme and their readiness to stick to the prescribed dosing is considered to be the most important condition on which successful treatment of asthma and COPD depends. With regard to this assumption, a study was designed whose aim was to find out how patients assess a particular powder inhaler, cyclohaler and to what degree they approve of its physical and technical features. MATERIAL AND METHODS: The study consisted in completing an anonymous questionnaire. The study group was recruited from asthmatic and COPD patients treated in outpatient units in Wroclaw and Lublin, Poland. 230 persons passed the recruitment stage, 220 completed the study. RESULTS: 96.4 and 94.5% of the patients ranked small size and low weight of the inhaler, respectively, as its most positive features, ranking the features higher than the device's colour (respectively p = 0.003 and p = 0.02). Other features, like dust protection and comfortable mouthpiece won almost equally high evaluation (respectively 97.3 and 98.2%). Most patients assessed these features as more important than discretion and easy handling and transportation (respectively p = 0.015 and p = 0.028). A high percentage of the study group praised the inhaler's technological efficacy. 94-96% at the least gave positive opinions about such features as: clear instruction, certainty of a dose's intake, the possibility of checking the amount of inhaled doses. CONCLUSION: The inhaler that was the object of the study enjoyed a high degree of acceptance mostly due to its features facilitating easy and efficient inhalation.
Subject(s)
Asthma/drug therapy , Nebulizers and Vaporizers , Pulmonary Disease, Chronic Obstructive/drug therapy , Adult , Anti-Asthmatic Agents/administration & dosage , Female , Humans , Male , Middle Aged , Patient Acceptance of Health Care , Patient Compliance , Patient Satisfaction , Surveys and QuestionnairesABSTRACT
AIM OF THE STUDY: The aim of this study was to evaluate the efficacy and safety of 3 years oral specific immunotherapy in patients with perannial allergic rhinitis and bronchial asthma caused by allergy to mites. MATERIAL AND METHODS: Fifteen patients with allergic perannial rhinitis entered the study. Ten of them suffered also from bronchial asthma. During 3 years of therapy we have monitored the appearance of side effects, clinical parameters (symptoms degree and medication usage score) and immunological parameters (serum eosinophil cationic protein concentration and leukotriene C4 liberation by peripheral blood leukocytes upon in vitro specific allergens stimulation). RESULTS: We have not observed the appearance of any adverse event, so medication has been recognized as a safe. Moreover, we have observed a lot of positive therapeutical effects--the lowering of symptoms scores, accompanied by advantageous changes in immunological parameters. However, in spite of 3 years of therapy, many patients still reported the substantial clinical symptoms, accompanied by still elevated serum ECP concentration and relatively high leukotriene C4 liberation by peripheral blood leukocytes upon in vitro stimulation by specific allergens. CONCLUSION: Oral specific immunotherapy in the patients with allergic diseases of upper airways is a safe medication but leads only to moderate clinical efficacy accompanied by lowering serum ECP concentration and reducing of leukotrienes C4 liberation by peripheral blood leukocytes stimulated by specific allergens.
Subject(s)
Immunotherapy/methods , Plant Extracts/therapeutic use , Rhinitis, Allergic, Seasonal/drug therapy , Rhinitis, Allergic, Seasonal/immunology , Administration, Oral , Adult , Animals , Dermatophagoides pteronyssinus , Eosinophil Cationic Protein/blood , Female , Humans , Leukotriene C4/blood , Male , Rhinitis, Allergic, Seasonal/diagnosis , Skin TestsABSTRACT
Specific immunotherapy (SIT) can in some cases influence the course of allergic inflammation (eosinophilia and ECP concentration in peripheral tissue). This study was set up to evaluate the efficacy of three-year pre-seasonal SIT with grass pollen allergoid. We measured NALf eosinophilia and ECP concentration both in NALf and blood serum after subsequent SITs. Twenty seven patients aged 26.7 +/- 7.4 (range 18-45) entered this study. They were randomly assigned to treatment with either Pollinex or Allergovit. We observed a progressive fall in NALf eosinophilia in subsequent years: 24.1 +/- 2.4%; 20.2 +/- 4.6%; 9.8 +/- 1.9% vs. 30.4 +/- 3.0% before treatment (p < 0.05, p < 0.05 and p < 0.001, respectively). Also ECP concentration fell after second and third SIT to 15.6 +/- 1.5 ng/ml i 12.96 +/- 1.75 ng/ml vs 23.3 +/- 3.7 ng/ml before SIT (p < 0.05). A significant drop in serum ECP concentration was recorded only after the third SIT season--2.5 +/- 1.23 micrograms/ml vs 5.8 +/- 1.3 micrograms/ml before treatment, p < 0.01. NALf eosinophilia correlated positively with NALf ECP concentration--R2 = 0.92, p < 0.05. Hence, SIT ameliorates allergic inflammation decreasing significantly activity of eosinophils in nasal mucosa measured as NALf eosinophilia and ECP concentration. This effect seems to be time-depended.
