Demographics |
1-Age (years) |
2- Gender |
Details of AIT & Causes of non compliance / poor compliance |
3-When did you start receiving the allergy injections? |
4-When did you stop receiving the injections? |
|
5- If you stopped your injection treatment, Why? |
1. Pain or reactions at injection site |
2. Time needed to wait after injections |
3. Frequent dosing schedule |
4. Long duration of treatment |
5. Distance from area of residence |
6. Pregnancy |
7. Doctors decision |
8. Difficult to leave work |
9. Others (please specify) |
|
Please answer the following questions if you were started on SLIT: |
6- When did you start taking allergy treatment (SLIT)? |
7-When did you stop taking allergy treatment drops under the tongue/SLIT |
|
8- If you stopped your treatment what are the reasons? |
1. Local reactions/ side effects (itching, pain, swelling under the tongue ) 2. Difficult dose schedule |
3. Long treatment duration |
4. No improvement with this treatment |
5. Improvement in symptoms, no need for treatment |
6. Pregnancy |
7. Doctor's decision |
8. Others (please specify) |