Michael Schatz, MD, MS, from Kaiser-Permanente in San Diego and colleagues surveyed a random sample of 3,568 patients with persistent asthma enrolled in an integrated health care system, to compare asthma care in patients seen by allergists vs. those seen by primary care providers. Of the patients who completed the assessment, 1,679 (47.1%) identified a primary care provider as their regular source of asthma care, 884 (24.8%) identified an allergist, 693 (19.4%) reported no regular source of asthma care, and 195 (5.5) identified a pulmonologist.
Patients under the care of an allergist were less likely to have required hospitalization or have unscheduled physician visits during the past year, compared to those seeing a primary care physician, and were also less likely to have overused Beta-agonists, a rescue medication, in the past year. They also were more likely to receive inhaled steroids, the preferred medication for the prophylactic treatment of chronic, persistent asthma. Inhaled steroids are effective in reducing airway inflammation, hypersensitivity, swelling and mucous production.
"These are important data that can be used by patients, payers, insurance companies and providers to improve outcomes for asthma patients," said Schatz, who is a past President of the AAAAI.
Compared to asthma patients who received care from a primary care physician, those seeing an allergist reported:
- Fewer asthma control problems
- Less severe asthma symptoms
- Significantly higher scores for asthma-specific quality of life and for overall general health.
- Significantly better understanding of how to manage their asthma and greater overall satisfaction with care
Asthma is a chronic disease that affects approximately 20 million Americans, and is responsible for nearly 5,000 deaths a year. In addition, there are nearly 2 million asthma-related visits to the emergency department each year.
"Patients with asthma should not have to miss school, work or recreational activities because of their symptoms," Schatz said. "This research shows that patients under the care of an allergist have better quality of life, fewer hospitalizations, need less rescue medication and generally report higher satisfaction with their quality of care."
Allergists are pediatric or internal medicine physicians who have elected an additional two years of training to become specialized in the treatment of asthma, allergy and immunologic disease. To assist patients and healthcare professionals in determining when referral to an allergist could be beneficial, the AAAAI has recently developed How the Allergist/Immunologist Can Help: Consultation and Referral Guidelines Citing the Evidence, which offers specific referral guidelines for 15 categories of allergic diseases. The new guidelines can be found on the AAAAI Web site, www.aaaai.org.
Established in 1943, the AAAAI has more than 6,000 members in the United States, Canada and 60 other countries. The AAAAI serves as an advocate to the public by providing educational information through its Web site at www.aaaai.org.
Journal
Journal of Allergy and Clinical Immunology