Purpose: Allergenic Specific Immuno-Therapy (SIT) has demonstrated to be efficient and well tolerated in the treatment of respiratory allergies, however many patients stop their SIT before full benefit is obtained. Our objective was to provide clinicians with a specific tool to improve compliance and better adapt care to the patient's characteristics, perceptions and behaviour.

Methods: An advisory committee of 6 allergy specialists was set up and involved at all stages of questionnaire development and validation. A conceptual model was derived from literature review, 5 allergy specialist and 21 patient interviews. A test questionnaire was developed with content validity being assessed on 5 patients. A revised questionnaire was pilot tested in clinical practice with 30 patients suffering from perennial allergic rhinitis by 10 clinicians. The pilot questionnaire was then administered by 211 clinicians to 571 patients suffering from allergic rhinitis (380 having a SIT and 191 about to start a SIT) between February and May 2005. After having experienced the use of the questionnaire, the clinicians had to rate their intentions regarding its future use in medical practice. The questionnaire was then reduced and scored, based on item contents, distributions, correlations.

Results: The broad concepts retained from literature and interviews were: symptom severity, function status, satisfaction, and adherence. The pilot questionnaire comprised 52 items in 10 sections (symptoms, allergy in daily life, motivations for desensitisation, advantages, constraints, intake, outcomes, satisfaction, continuation of SIT, information). Eight items were specific to SIT-naïve patients, 21 to patients having a SIT. The mean percentage of missing data was 2.16 for treated patients and 1.46 for naïve patients. The clinicians reported high patient acceptability and major interest for using the questionnaire routinely. The prioritisation given to the sections was: symptoms, satisfaction, outcomes, continuation, allergy in daily life, intake, information, inconvenient, advantages for treated patients. For naïve patients the prioritisation given was: motivation, symptoms, allergy in daily life, information, advantages, inconvenient.

Conclusions: This self-reported questionnaire is a flexible, pragmatic tool allowing clinicians to better manage their patients in clinical practice. It is well accepted by patients and perceived as useful by clinicians. It is now available for inclusion in a prospective longitudinal study which will show its ability to predict persistence problems.