The respiratory allergy patient's healthcare journey: An international qualitative survey employing an ethnographic approach

Respiratory allergy (RA), one of the most prevalent global chronic diseases, is often suboptimally managed by both patients and healthcare professionals (HCPs). This qualitative survey investigated the RA healthcare journey from the patient perspective to better understand the challenges faced at key stages and the unmet needs for potential improvements in physician-patient relationship, shared decision-making and patient quality of life outcomes. The survey employed an ethnographic approach consisting of getting rid of any preconceived ideas and adopting an attitude of listening and empathy devoid of any prejudices. It involved 105 participants distributed across 3 countries (France, Germany, and Italy) who took part in a 2-h interview. All were diagnosed with intermittent or persistent RA and were at different stages of the journey/treatment (without treatment, antihistamine, undergoing Allergen Immunotherapy [AIT], completed AIT, reluctant to AIT, or discontinued AIT). Regional differences and variations related to medical subspecialties are considered, offering a comprehensive and nuanced perspective on RA management at an international level. The examination of a complex and lengthy journey revealed 4 key stages and explored the corresponding emotional experiences. Physician-patient communication, clinical and emotional support and timing are found to be crucial factors in treatment choice, adherence and the psychological impact of the journey. Additionally, the data collected identified 4 distinct profiles related to AIT, based on their approach to managing RA and their level of access to treatment information: the "skeptic", the "skittish", the "determined", and the "convinced". This patient stratification can help physicians tailor their strategies and adopt more personalized approaches.