Engaging the Patients in Shared Decision-Making

Healthcare professionals have become involved in shared decision making (SDM), which empowers patients to have an active role in their own treatment and increases the success rates of clinical management decisions.12 A study conducted between 2002 and 2014 using the Medical Expenditure Panel Survey found that patient-reported use of SDM increased significantly.13 This means that healthcare providers are increasingly encountering well-informed patients who want to participate in SDM.

SDM is one of the constituents of personalized medicine,14 and can be especially useful for improving adherence to allergen immunotherapy.15 The American College of Allergy, Asthma and Immunology (ACAAI) developed a new AIT SDM tool to help clinicians and patients better manage AR. In addition, SDM experts suggest that providers consider the following important questions when considering immunotherapy treatment options: i) how well the patient’s symptoms are controlled with other treatment measures (avoidance and pharmacotherapy); ii) is the patient interested in decreasing pharmacotherapy use; iii) is the patient aware of the financial and time commitments associated with immunotherapy; iv) does the patient prefer SCIT or SLIT and is he/she aware of the potential side effects of these treatments?14

ODACTRAImportant Safety Information

WARNING: SEVERE ALLERGIC REACTIONS

  • ODACTRA can cause life-threatening allergic reactions such as anaphylaxis and severe laryngopharyngeal restriction.
  • Do not administer ODACTRA to patients with severe, unstable or uncontrolled asthma.
  • Observe patients in the office for at least 30 minutes following the initial dose.
  • Prescribe auto-injectable epinephrine, instruct and train patients on its appropriate use, and instruct patients to seek immediate medical care upon its use.
  • ODACTRA may not be suitable for patients with certain underlying medical conditions that may reduce their ability to survive a serious allergic reaction.
  • ODACTRA may not be suitable for patients who may be unresponsive to epinephrine or inhaled bronchodilators, such as those taking beta-blockers.

ODACTRA is contraindicated in patients with:

  • Severe, unstable, or uncontrolled asthma
  • A history of any severe systemic allergic reaction
  • A history of any severe local reaction after taking any sublingual allergen immunotherapy
  • A history of eosinophilic esophagitis
  • Hypersensitivity to any of the inactive ingredients [gelatin, mannitol and sodium hydroxide] contained in this product

ODACTRA can cause systemic allergic reactions including anaphylaxis which may be life-threatening. In addition, ODACTRA can cause severe local reactions, including laryngopharyngeal swelling, which can compromise breathing and be life-threatening. Educate patients to recognize the signs and symptoms of these allergic reactions and instruct them to seek immediate medical care and discontinue therapy should any of these occur. Allergic reactions may require treatment with epinephrine.

Prescribe auto-injectable epinephrine to patients receiving ODACTRA. Instruct patients to recognize the signs and symptoms of a severe allergic reaction and in the proper use of emergency auto-injectable epinephrine. Instruct patients to seek immediate medical care upon use of auto-injectable epinephrine and to stop treatment with ODACTRA. Review the epinephrine package insert for complete information.

Administer the initial dose of ODACTRA in a healthcare setting under the supervision of a physician with experience in the diagnosis and treatment of allergic diseases and prepared to manage a life-threatening systemic or local allergic reaction. Observe patients in the office for at least 30 minutes following the initial dose of ODACTRA.