Drago®: An innovative mobile application to improve adherence and complience of house dust mite allergen immunotherapy

• Allergen immunotherapy (AIT; allergen desensitization) is the only disease-modifying treatment for IgE allergies. • Only 18 % patients complete the required 3-year treatment course. • A novel app Drago® aims at tracking treatment adherence and burden of respiratory disease. • The app empowers patients to self-monitor symptoms, share decisions with physicians and access education for AIT management. • Drago® app in France boosts AIT use via education, tracking, and gamified adherence, modeling e-health in clinical care. House dust mite (HDM) allergens constitute the most frequent cause of persistent allergic rhinitis and asthma. Allergen immunotherapy (AIT) is the only disease-modifying treatment for patients suffering from IgE-mediated allergic conditions. The Drago® application is a free application to optimize the use of AIT through education modules, timing track and implementation of adherence based on games and avatar evolution. Consecutive patients were offered to voluntarily use the application simultaneously to their AIT. We evaluated data related to patients’ adherence to HDM AIT over 3 years. Data generated were anonymized and stored following the French regulations. Compliance referred to the ratio of the number of doses taken by the patient to the duration of APP use by the patient, expressed as a percentage. Adherence was measured by comparing measured persistence (duration between the last date of the application use and starting date of treatment) with ideally expected persistence. Quality of life (QoL), Allergic Rhinitis Control Test (ARCT) and Global Initiative for Asthma (GINA) control scores have been evaluated at three different time points: the first, second, and third years of application use). From overall 4,906 users after 3 years of launch, 2,490 (50.7 %) were undergoing HDM AIT, with 244,200 numbers of accesses to the Drago® application. Mean age of users was 21 years, most of patients were children (74.6 %). Number of accesses overtime by children were proportionally higher than by adults and adolescents. Over 80 % percent of patients used the application from 7:00 to 10:00 AM (27.2 %) and from 18:00 to 21:00 PM (53.7 %). At year 3, mean rate of compliance over a period of three years was 45 % (confidence interval [CI]: 44.1 %–46.1 %), mean persistence was estimated in 327 days (CI: 315–337 days), with 76 % of mean percentage adherence (CI: 74.9 %–76.7 %). Persistence and adherence were significantly higher in children, but compliance was more significant in adults. We observed significant improvements in the mean ARCT, and QoL scores across three time points (first year, second year and third year). Positive impact on adherence, persistence and burden of respiratory diseases were observed in patients using Drago® application and undergoing HDM AIT, in particular in childhood. Consolidating the presented data with the English version of Drago® application will soon be available.