Mapping the Treatment Journey of Children on Subcutaneous House Dust Mite Immunotherapy: A Qualitative Study

Abstract

Background: Although subcutaneous immunotherapy (SCIT) is a first-line treatment for the prevalent house dust mite allergy (affecting ~30% of children in humid regions), the longitudinal realities of managing this years-long therapy for children and their parents/carers are poorly documented. Methods: We conducted semi-structured interviews with 15 child-caregiver dyads (children aged 6–12 years) undergoing SCIT. Data were analyzed using framework analysis to map challenges across four treatment phases: diagnosis/screening, initiation, maintenance, and follow-up. Results: Key findings included: Diagnostic delays (mean 10.2 months) due to non-specific symptoms (86.7% morning sneezing). Injection anxiety (initial Visual Analog Scale (VAS): 7.8/10) improved with play-based interventions (64% reduction). School challenges: 64.2% faced symptom management difficulties; 57.1% experienced peer stigma. Economic burden: Annual direct costs averaged ¥8750 (US$1250). Conclusion: This study identifies modifiable gaps in SCIT delivery, advocating for: Early symptom recognition tools, Child-friendly anxiety-reduction protocols, and School-based support programs. The proposed “hospital-school-family” tripartite system may optimize outcomes globally.