Asia Pac Allergy.  2014 Jan;4(1):48-53. 10.5415/apallergy.2014.4.1.48.

Frequently asked questions in allergy practice

• Tan XX
• Xie P
• Kwek JL
• Kwek SY
• Yang Z
• Soon W
• Leong JL
• Wang DY

• KMID: 2397126
• DOI: http://doi.org/10.5415/apallergy.2014.4.1.48

Abstract

BACKGROUND
Over the last 10-20 years, international guidelines and consensus statements for the management of common allergic diseases (e.g. allergic rhinitis and asthma) have been developed and disseminated worldwide. However, their impact on knowledge and standard of clinical practice among primary care physicians and specialists is unknown.
OBJECTIVE
To investigate need for an improvement in the dissemination of international guidelines for the diagnosis and management of allergic rhinitis.
METHODS
Seven medical students who attended 3-day 1st International Basic Allergy Course (2010) took down all questions raised during the entire course. A systemic analysis of these questions was performed to identify areas for improvement in diagnosis and management of allergic diseases mainly in the Association of Southeast Asian Nations (ASEAN) region.
RESULTS
268 participants, 143 males and 125 females, comprising Ear, Nose and Throat (ENT) specialists (n = 106) and trainees (n = 34), general practitioners (n = 87), and other healthcare professionals (n = 41) attended the course. Of the 103 questions recorded, 59 were regarding treatment modalities in allergy practice such as immunotherapy (n = 38), pharmacologics (n = 15), nasal surgery (n = 2), and others (n = 4). 41 questions (39.8%) have answers based in the Allergic Rhinitis and its Impact on Asthma guidelines (2001 and 2008). Certain questions were selected for further analysis because they appeared to be (a) more commonly asked (e.g. immunotherapy) or (b) were deemed to be challenging or, even controversial (e.g. food allergy and differential diagnosis between vasovagal and anaphylaxis reaction), as the recommendations in current international guidelines were less well-defined.
CONCLUSION
Our study identified several problems that, if tackled, could help minimize confusion and provide better care for patients suffering from allergic diseases especially in the ASEAN region.

Keyword

Allergic diseases; International guidelines; Management; Immunotherapy; Vasovagal and anaphylaxis reaction; Food allergy

MeSH Terms

Anaphylaxis
Asian Continental Ancestry Group
Asthma
Consensus
Delivery of Health Care
Diagnosis
Diagnosis, Differential
Ear
Female
Food Hypersensitivity
General Practitioners
Humans
Hypersensitivity*
Immunotherapy
Male
Nasal Surgical Procedures
Nose
Pharynx
Physicians, Primary Care
Rhinitis, Allergic
Specialization
Students, Medical

Figure

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  Fig. 1 Categorization of questions.

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  Fig. 2 Treatment questions.

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  Fig. 3 Types of adverse reactions to food as classified by European Academy of Allergology and Clinical Immunology [7].

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