АЛЛЕРГЕН-СПЕЦИФИЧЕСКАЯ ИММУНОТЕРАПИЯ: ЭФФЕКТИВНОСТЬ, ПРОДОЛЖИТЕЛЬНОСТЬ, МЕТОДЫ И ФАРМАКОЭКОНОМИКА

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Несмотря на то, что аллерген-специфическая иммунотерапия (АСИТ) более ста лет применяется для лечения аллергического ринита (АР), аллергического конъюнктивита, астмы, атопического дерматита и гиперчувствительности к укусам насекомых, она постепенно достигла всеобщего признания. С опубликованием в 1998 году «Позиционного документа Всемирной организации здравоохранения аллерген-специфической иммунотерапии», в котором обобщены научные данные об эффективности и долгосрочной пользе этого способа терапии, аллерген-специфическая иммунотерапия стала признанной и уважаемой формой лечения. В обзоре обсуждаются следующие темы аллерген-специфической иммунотерапии: причины рекомендации по терапии АСИТ, механизм действия, подкожные и сублингвальные методы применения, продолжительность лечения, соблюдение пациентом назначений врача и экономическая эффективность. Особое внимание уделяется необходимости поддерживать, а не обвинять пациента в несоблюдении назначений врача, поскольку пациент, врач и система здравоохранения в целом должны заботиться о создании среды, в которой пациент будет неукоснительно соблюдать назначения врача. Несоблюдение пациентом назначений врача является следствием большого количества факторов, и врач должен учитывать все факторы с целью обеспечения соблюдения пациентом всех рекомендаций. Желание пациента соблюдать назначения врача необходимо рассматривать в динамике с целью выбора наилучшего времени для начала АСИТ, также необходимо обеспечить наблюдение за пациентом в течение нескольких лет после проведенной АСИТ. Пациент, неукоснительно исполняющий назначения врача в первый год лечения, не сможет быть столь же последовательным на третьем году терапии без дополнительной поддержки. Система здравоохранения и профессиональные организации должны помочь в обучении врачей эффективным и точным способам оценки причин несоблюдения пациентами назначений врача и осуществления мер по оптимизации приверженности пациентов к лечению на продолжении длительного срока. Междисциплинарный подход к решению этой проблемы потребует участия медицинских работников, исследователей, профессиональных организаций, страховых компаний и лиц, определяющих политику в сфере здравоохранения.

Об авторах

Д Уоллес

Современная Школа медицины Юго-Восточного Университета, Форт-Лодердейл, Флорида, США

Email: drdanawallace@gmail.com

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© Уоллес Д., 2018

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