1. HISTORY

Download

2. CONFIRM
The most common allergens are:1

3. MANAGE
Action plan

Download

Exposure
reduction advice

Download

Management

Confirm the likely triggers

Interpret the test results alongside the allergy-focused clinical history.2 A specific IgE result of ≥0.1 kUA/L indicates sensitisation

Following the confirmation of triggers consider the following guidance:

Patient with...**

Asthma and confirmed house dust mite allergy

  • Provide exposure reduction advice3
  • Consider regular antihistamines and nasal steroids if symptoms persist

Asthma and confirmed pollen/mould allergy

  • Provide exposure reduction advice to the specific mould or pollen
    Visit Allergy UK
  • Consider seasonal daily antihistamines and nasal steroids targeted to the peak pollen/mould season
    View the pollen calendar
  • For patients with sensitisation to mould, especially Alternaria Sp. provide advice around minimising exposure before and after thunder storms4
  • Consider adapting asthma medication

Asthma and confirmed pet allergy

  • Provide exposure reduction advice to the specific pets
    Visit Allergy UK
  • Optimise treatment and consider regular antihistamines

Asthma and confirmed food allergy

  • Refer to secondary care
  • Ensure the patient's asthma is well controlled and consider prescribing an adrenaline autoinjector

*Skin prick tests should be undertaken where there are facilities to deal with anaphylactic reaction2

**Adapted from expert-endorsed asthma history template. Click here to download

Printable action plans

To ensure your patient follows your management advice, it is important to provide them with an action plan.

Download these useful action plans to guide your management of allergy patients:

  • Allergy action plan Download
  • Anaphylaxis action plan Download
  • Anaphylaxis action plan for children with asthma Download

Allergy identification and management can improve outcomes for your asthma patients

Allergy Identification and Management can improve asthma care:

  • 22% reduction in unscheduled care in patients with allergic diseases in 12 months5
  • 13% reduction in Accident & Emergency visits for respiratory and allergic conditions5

Allergen avoidance or desensitisation improves symptoms in patients with asthma:

  • 30% reduction in asthma symptoms with improved indoor environment6

Expert Opinion: Professor Somnath Mukhopadhyay discusses how allergen exposure reduction impacts asthma control

Allergy identification and management can reduce medication use

Initial specific IgE blood testing reduces medication use over two years:7

  • IgE blood testing improved accuracy of diagnosis to 85-97% - from 30-65% using only case history and physical examination7
  • Positive IgE results can be used to guide allergen avoidance recommendations and treatment selections7

*The basis for the economic evaluation and the clinical decision model was a non-randomised clinical trial investigating the addition of specific IgE testing of blood on the current management by primary care physicians of 721 children with respiratory and/or skin symptoms in Spain and Italy7

Reducing exposure to allergic asthma triggers reduces severe exacerbations

  • Risk of further asthma exacerbations requiring a hospital visit/stay was reduced by 45% for children whose bedding (mattress, pillow and duvet) was fitted with mite-impermeable coverings (HR 0.55, 95% CI 0.36–0.85, p=0.006)3
  • 29.3% of children in the active group attended hospital with one or more severe asthma exacerbation vs. 41.5% in the placebo group (OR 0.58, 95% CI 0.34–0.99, p=0.047)3
  • There was no difference between the groups in the risk of oral steroid use for asthma exacerbations (HR 0.82, 95% CI 0.58-1.17, p=0.28)3

Results of a randomised, double-blind, placebo-controlled parallel-group study of the effect of mite-impermeable bed covers on the risk of severe asthma exacerbations in mite-sensitised asthmatic children aged 3-17 conducted across 14 hospitals in NW England.3 *Severe exacerbation, defined as an asthma hospitalisation or emergency department visit requiring systemic corticosteroids.

Burden of Asthma

300 million people
300 MILLION
PEOPLE

Asthma affects approximately 300 million people in the world,8 5.4 million people in the UK.9 More than 80% of people with asthma also suffer from rhinitis8

300 million people
INCREASED RISK OF
FATAL ANAPHYLAXIS

Patients with asthma, plus allergy to peanuts or tree nuts, are at an increased risk of fatal anaphylaxis.9,10 It has been demonstrated that early diagnosis followed by active management can reduce asthma costs by more than half8

300 million people
3 PEOPLE STILL DIE
EVERY DAY FROM ASTHMA

The NHS spends around £1 billion a year treating and caring for people with asthma. Despite this asthma exacerbations hospitalise someone every 8 minutes, hospitalise a child every 20 minutes and on average 3 people die a day from asthma11


How likely would you be to recommend this content?

Rate this content

Please select an option.
Thank you for your response
References
  1. NHS Asthma; www.nhs.uk/conditions/anaphylaxis/pages/causes.aspx; last accessed June 2016
  2. National Institute for Health and Clinical Excellence. Food allergy in children and young people (CG116). 2011. London: National Institute for Helth and Clinical Excellence.
  3. Murray CS, et al. Am J Respir Crit care Med 2017; doi: 10.1164/rccm.201609-1966OC [Epub ahead of print].
  4. D'’Amato G, et al. Clin Exp Allergy 2016;46:390-396.
  5. Morgan WJ, et al. N Engl J Med. 2004;351(11):1068-1080.
  6. Wickman M. Allergy 2005;60 (suppl 79):14-18.
  7. Zethraeus N, et al. Italian Journal of Pediatrics 2010;36:61.
  8. Pawankar R (Ed), et al. White book on allergy, 2011; World Allergy Organisation UK.
  9. Simons FER, et al. Int Arch Allergy Immunol 2013; 162: 193-204.
  10. Punekar YS and Sheikh A. Clin Exp Allergy 2009; 39:1889-1895.
  11. Asthma UK. Available from https://www.asthma.org.uk/about/media/facts-andstatistics/;last accessed April 2017.

Interested in our Allergy/Autoimmunity Education?

What disease states are you most interested in learning about?

By submitting this form, you agree to the Thermo Fisher Scientific Privacy Policy and agree to receive email communications from Thermo Fisher Scientific.

Your details have successfully been submitted.