I have just been reading a report of a study on allergic rhinitis sufferers (35-40% of the US population). Despite the fact that immunotherapy has been around for nearly 100 years, is recognised as the best treatment for allergic rhinitis and is the only treatment which actually improves the condition rather than just treating the symptoms, only 36% of sufferers opted to take the treatment when offered.
(In immunotherapy the patient is injected with, or ingests under the tongue, tiny amounts of the relevant allergen over several years to gradually ‘induce tolerance’.)
Now this study was entirely funded by Merck who make the immunotherapy treatments so it would be reasonable to treat it with a degree of scepticism as it is obviously in Merck’s interest to encourage a greater uptake of their medication. However, my experience with hay fever sufferers in the garden world suggest that it is not far off the mark.
Regular readers may remember that I was sounding off a few weeks ago about the dearth of allergen free gardens at Chelsea Flower Show. Well, in the various conversations that I have had with gardeners and garden designers over the years, I have been amazed how many of them preferred to stick with dopey-making antihistamines (which they all claimed to hate) rather than experiment with low allergen plants or, indeed, alternative forms of treatment. So maybe the fact that 64% of 8,790 patients from an allergy clinic in Pennsylvania refused to even try the immunotherapy treatments on offer should not come as so much of a surprise.
(If you want the nitty gritty of the trial it appeared in the Annals of Allergy, Asthma and Immunology in May, but these were the headline findings :
• Only 36% chose the treatment
• Of these, 75% chose allergen injections rather than under the tongue drops.
• 40% quit before completing 3 years of treatment, most quit before completing the full 5 years.
• Patients continued using the allergy shots longer than the drops (maybe because using the shots involved a visit to the doctor) and children continued longer than adults.
• Most people did not give a reason for stopping although half of those who stopped the sub-lingual drops did so because they did not like the taste.)
But what intrigues me is why people are so reluctant to try treatments which offer reliable and proven benefits, preferring to stick with ‘what they know’ – even when they know that ‘what they know’ does a lousy job! If one was suggesting something potentially dangerous (major surgery), with terrible side effects (chemotherapy), apparently contrary to recent medical science (inoculating yourself with worms) or just straight yucky (FMT or poo transplants) I could understand that one would want to think seriously before embarking on such a treatment. But taking few drops under the tongue for a few years, or planting a few different flowers? What on earth is scary about them and why, if one suffers badly with allergic rhinitis or, indeed, any other medical condition, would one not at least give them a try?
If anyone has any suggestions I’d love to hear them!
Its probably a variation on white coat syndrome. Dramatic treatments carried out by teams of highly qualified doctors with expensive machinery in hospitals, has to be more effective than yucky tasting drops. Committing yourself to a treatment protocol that has to be continued regularly for 5 years is quite a commitment. We live in the age of the quick ‘cure’ achieved by high tech drugs or surgical interventions . Helping the body to cure itself is an approach unfamiliar to most people.