Patients' perspective on allergen immunotherapy for respiratory allergy

Purpose of review: This review explores patients' perspective on allergen immunotherapy (AIT) for respiratory allergy, addressing awareness, motivations, adherence challenges, perceived benefits and risks, and the importance of education and shared decision-making. It also summarizes the data on patient-reported outcomes, considers the role of patient associations, and outlines future directions for enhancing adherence and advancing patient-centered care. Recent findings: AIT is the only treatment capable of modifying the natural course of allergic diseases, providing lasting benefits in terms of symptom reduction, quality of life (QoL), and asthma control. Despite its efficacy and safety, AIT remains underused due to several factors, including cost, misinformation, patient skepticism, and adherence challenges. Limited reimbursements further restrict access. Summary: The patient's perspective is crucial in AIT, as it directly impacts adherence and treatment outcomes. Allergic rhinitis and asthma significantly reduce the QoL, especially when poorly controlled, but their burdens are often underestimated. Adherence to AIT depends on multiple factors including age, physician engagement, perceived efficacy, convenience, education, and socioeconomic status. Effective communication, shared decision-making, and tailored education enhance long-term compliance, while financial barriers and lack of reimbursement remain significant obstacles. Patient-reported outcome measures (PROMs) are essential tools for assessing symptom burden, disease control, and QoL, supporting clinical decisions and research. Validated PROMs, as well as combined symptom-medication scores, help personalize care and are increasingly integrated into digital platforms for real-time monitoring. Respiratory patient associations play a vital role in promoting education, empowerment, and advocacy, enhancing adherence and access to care.