Reflective Practive

Asthma

Allergies trigger asthma exacerbations in 60-90% of children and 50% of adults with asthma1

Asthma affects approximately 300 million people in the world,1 5.4 million people in the UK2.

Positive tests for allergy in wheezing children increases the likelihood of asthma, and a raised specific IgE to wheat, egg white, or inhalant allergens can predict later childhood asthma3

More than 80% of people with asthma also suffer from rhinitis1. Patients with asthma, plus allergy to peanuts or tree nuts, are at an increased risk of fatal anaphylaxis.4,5 It has been demonstrated that early diagnosis followed by active management can reduce asthma costs by more than half1

The benefits of allergy testing

Targeted management of atopic patients could reduce the healthcare burden6,7

Is there a suspicion of allergy?

1. Go beyond symptoms and identify the cause

  • Avoid unnecessary prescriptions
  • Avoid unnecessary consultations
  • Reduce the prescription burden and save costs
  • Reduce time off school, college or work and reduce waitling lists
  • Save time, costs and help patients live a less encumbered life

2. Early diagnosis of allergy

  • Reduce emergency admissions
  • Avoid unnecessary prescriptions / consultations / referrals
  • Improve control
  • Enable patients to take part in normal daily activities
  • Save time, costs and help patients live a less encumbered life

3. Determine the right treatment plan

  • Reduce emergency admissions
  • Avoid unnecessary prescriptions / consultations / referrals
  • Improve control
  • Enable patients to take part in normal daily activities
  • Save time, costs and help patients live a less encumbered life

4. Active management

  • Improve quality of life

What are the clinical benefits of testing for components?

Allergen component diagnostics measure IgE to particular allergen components, uncovering additional information about an underlying allergy.

Not only do they indicate specific allergen reactivity in the way that whole extracts do but they are also indicators for:
1

understand patient risk - add confidence to your assessment

1

selecting patients for immunotherapy - useful for venom and aero-allergy patient selection

Understanding cross-reactions between species - help to understand multiple sensitisations e.g. in pollen-food syndrome

What do the experts say?

References
  1. Pawankar (Ed) et al., White book on allergy, 2011; World Allergy Organisation UK.
  2. UK Facts. Available at: http://www.asthma.org.uk/asthma-facts-and-statistics; Last accessed April 2013.
  3. British Thoracic Society and Scottish Intercollegiate Guidelines Network. British Guideline on the Management of Asthma. 2014.
  4. Simons FE, et al. Int Arch Allergy Immunol 2013; 162: 193-204.
  5. Punekar YS and Sheikh A. Clin Exp Allergy 2009; 39:1889-1895.
  6. House of Lords, Science and Technology sixth report- the extent and burden of allergy in the United Kingdom. Available from http://www.bsaci.org/pdf/HoL_science_report_vol.1.pdf; last accessed July 2015.
  7. Pearce L. Nursing Times 2012; 108(17): 20-22.

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