Time required for specific immunotherapy with subcutaneous and sublingual administration in clinical practice

Time required for specific immunotherapy with subcutaneous and sublingual administration in clinical practice Background: Available therapeutic options for specific immunotherapy (SIT) include products for subcutaneous (SCIT) and sublingual (SLIT) administration. Their efficacy and tolerability have been studied in clinical trials, and they can be used in accordance with the German S2 guidelines on SIT. To date, little is known about the time it takes to carry out SCIT or SLIT in the clinical practice of non-hospital-based specialists per patient and year. Amongst other things, such figures are, however, important for economic calculations. Methods: Data were collected from 545 patients (SCIT: n = 274; SLIT: n = 271) in 52 allergology practices. Each individual step of patient management was timed, with a stopwatch whenever possible, and the times recorded in a standardised case report form. Results: Each year, on average, SLIT required 1.22 hours per patient, while the figure for SCIT was 6.03 hours per patient. The time involved in the initial stages was longer for SLIT than SCIT. Writing purchasing orders and prescriptions took about the same amount of time (about three minutes) for the two routes of administration. The difference between the overall times arose because almost twice as many visits to the doctor were required for SCIT than for SLIT (8 to 9 vs. 4 to 5), in addition to the time taken to prepare and administer the injections and the subsequent 30-minute waiting time. Conclusions: The difference between SCIT and SLIT in the time required is 4.81 hours on average in favour of SLIT. Given the fact that products for evidence-based treatment are available in equal measure for both SLIT and SCIT, the time factor involved in the two administration routes should also be included in therapeutic considerations.