The roadmap for the Allergology specialty and allergy care in Europe and adjacent countries. An EAACI position paper

Fyhrquist, Nanna; Werfel, Thomas; Bilò, Maria Beatrice; Mülleneisen, Norbert; Wijk, Roy Gerth van

doi:10.1186/s13601-019-0245-z

Cited by 29 publications

(38 citation statements)

References 11 publications

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“…8 French patients may find some difficulty in accessing an allergist practitioner and receiving an allergy work-up. 9 Better knowledge of allergies is critical for providing the best care to a great number of French people suffering from these symptoms. For a great number of allergic people, respiratory, food, and skin allergy symptoms create a significant burden through anxiety, relationship degradation, embarrassment, and frequent disturbances of normal tasks, all contributing to a poorer quality of life.…”

Section: Discussionmentioning

confidence: 99%

Allergy Prevalence in France and Skin Impact – Epidemiological Survey of a Representative Sample of French Adults

Seité

Taïeb²,

Pham‐Thi³

et al. 2021

CCID

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Background: Increased allergy frequency may have a significant impact on the skin, one of the largest targeted organs for allergic and immunological responses. Methods: An online survey of 2036 adults as a representative sample of the French general population was conducted to evaluate the prevalence of self-reported allergies, the populations who report allergies and the skin conditions related to allergies. Results: In general, 20.2% of French adults (average age 45 ± 15.8 years) reported allergies. These allergies were respiratory allergies (55.3%), skin allergies (48.8%) and food allergies (27.9%), and 78.9% indicated that their reported allergies were diagnosed by a doctor. In addition, 53.2% of individuals reporting an allergy also indicated that they experienced associated skin reactions. In comparison to those who did not report an allergy, these individuals were 1.5 to 4 times more likely to have a skin disease and 3 times more likely to have sensitive skin or skin reactions when using skincare products. Conclusion:It is estimated that over 10 million French adults have allergies. These data will help increase awareness among the allergic population and healthcare professionals about the burden associated with allergies and the need for management to reduce their health impact.

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Section: Discussionmentioning

confidence: 99%

Allergy Prevalence in France and Skin Impact – Epidemiological Survey of a Representative Sample of French Adults

Seité

Taïeb²,

Pham‐Thi³

et al. 2021

CCID

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“…There are significant differences worldwide regarding the recognition of Allergy as clinical specialty and the prevalence of practicing specialists, with many countries in Latin America and Europe lacking Allergy as either specialty or subspecialty. 54 , 55 This leads to variable waiting times between each “stage” in the journey, which may leave the patient with prolonged periods of no support, as seen in Hong Kong, where the ratio of adult allergists to patients can reach 1:2.8 million. 51 There is also heterogeneity in the nature of third-level care, for instance in the use of allergy immunotherapies between the United States and Europe.…”

Section: Variations In the Allergy Care Infrastructurementioning

confidence: 99%

Harmonizing allergy care–integrated care pathways and multidisciplinary approaches

Daniels

Barker

Chang

et al. 2021

World Allergy Organization Journal

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There is a wide time gap between the publication of evidence and the application of new knowledge into routine clinical practice. The consequence is sub-optimal outcomes, particularly concerning for long-term relapsing/remitting conditions such as allergic diseases. In response, there has been a proliferation of published guidelines which systematically review evidence for the gold-standard management of most allergic disorders. However, this has not necessarily been followed by improved outcomes, partly due to a lack of coordination across the patient pathway. This has become known as the "second translational gap". A proposed solution is the development and implementation of integrated care pathways (ICPs) to optimize patient outcomes, with the notion that evidence-based medicine requires evidence-based implementation. ICP implementation is shown to improve short-term outcomes for acute conditions and routine surgery, including reduced length of hospital stay, improved documentation and improved patient safety. However, this improvement is not reflected in patient experience or patient-centered functional outcomes. The implementation of life-long, cost-effective interventions within comprehensive pathways requires a deep appreciation for complexity within allergy care. We promote an evidence-based methodology for the implementation of ICPs for allergic disorders in which all stakeholders in allergy care are positioned equally and encouraged to contribute, particularly patients and their caregivers. This evidence-based process commences with scoping the unmet needs, followed by stakeholder mapping. All stakeholders are invited to meetings to develop a common vision and mission through the generation of action/effect diagrams which helps build concordance across the agencies. Dividing the interventions into achievable steps and reviewing with plan/do/study/act cycles will gradually modify the pathway to achieve the best outcomes. While the management guidelines provide the core knowledge, the key component of implementation involves education, training, and support of all healthcare professionals (HCPs), patients and their caregivers. The pathways should define the level of competence required for each clinical task. It may be useful to leave the setting of care delivery or the specific HCP involved undefined to account for variable patterns of health service delivery as well as local socioeconomic, ethnic, environmental, and political imperatives. In all cases, where competence is exceeded, it is necessary to refer to the next stage in the pathway. The success and sustainability of ICPs would ideally be judged by patient experience, health outcomes, and health economics. We provide examples of successful programs, most notably from Finland, but recommend that further research is required in diverse settings to optimize outcomes worldwide.

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“…Allergic diseases are clinically and immunologically multifaceted, as well as pathogenetically heterogenous ( 15 ), which makes an evidence-based clinical diagnosis rather challenging. Moreover, the ratio of allergists per allergic patient is in general rather low and highly heterogenous in different countries ( 19 , 20 ). As a first point of contact, most allergic patients see a primary care doctor, who frequently lacks the knowledge, confidence or resources to meet their specific needs due to insufficient training ( 21 ).…”

Section: Clinical Decision Support For Allergic Diseasesmentioning

confidence: 99%

The Potential of Clinical Decision Support Systems for Prevention, Diagnosis, and Monitoring of Allergic Diseases

et al. 2020

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Clinical decision support systems (CDSS) aid health care professionals (HCP) in evaluating large sets of information and taking informed decisions during their clinical routine. CDSS are becoming particularly important in the perspective of precision medicine, when HCP need to consider growing amounts of data to create precise patient profiles for personalized diagnosis, treatment and outcome monitoring. In allergy care, several CDSS are being developed and investigated, mainly for respiratory allergic diseases. Although the proposed solutions address different stakeholders, the majority aims at facilitating evidence-based and shared decision-making, incorporating guidelines, and real-time clinical data. We offer here an overview on existing tools, new developments and novel concepts and discuss the potential of digital CDSS in improving prevention, diagnosis and monitoring of allergic diseases.

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The roadmap for the Allergology specialty and allergy care in Europe and adjacent countries. An EAACI position paper

Cited by 29 publications

References 11 publications

Allergy Prevalence in France and Skin Impact – Epidemiological Survey of a Representative Sample of French Adults

Allergy Prevalence in France and Skin Impact – Epidemiological Survey of a Representative Sample of French Adults

Harmonizing allergy care–integrated care pathways and multidisciplinary approaches

The Potential of Clinical Decision Support Systems for Prevention, Diagnosis, and Monitoring of Allergic Diseases

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