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New Allergy Guidelines Seek to Empower Patients

WebMD Health News

March 5, 2000 (San Diego) -- Consumers now have an important new weapon in their quest to achieve proper treatment for their asthma and allergies in the form of major new guidelines released today by the American Academy of Allergy, Asthma, and Immunology (AAAAI). According to Gary S. Rachelefsky, MD, past president of the AAAAI, "The whole idea of this effort is to promote better patient outcomes" by educating doctors, patients, insurers, and politicians about the importance of proper diagnosis and treatment of allergies and asthma.

Often considered more of a nuisance than an illness, allergic disease is actually the sixth leading cause of chronic disease in the U.S. and affects more than 50 million children and adults, says Harold S. Nelson, MD. "In other words, more than 20% of the population has at least one of the conditions that we cover." Each year, allergies account for more than $18 billion in health care costs, but proper management and patient education could save as much as $1.4 million per 1,000 employees in the workplace, in terms of lost time and diminished productivity, Nelson says. He is chairman of the task force of 21 medical and health care organizations, including the AAAAI, which produced the report.

Patients as well as physicians often don't realize how serious allergies may be, he warns. Many patients simply treat their symptoms with over-the-counter medications such as antihistamines. Often, the result is not only inadequate or inappropriate treatment of the allergy, but significant side effects from the drugs themselves. According to allergist Mark T. O'Hollaren, MD, one of the report's reviewers, "There is evidence that over-the-counter medications can affect the ability to drive more than legal intoxication." O'Hollaren is a professor at Oregon Health Sciences University in Portland.

One of the goals of the report is to identify and overcome barriers to appropriate care, which, says Rachelefsky, is really a "smorgasbord" of factors, including inadequate or inaccurate diagnosis, ignorance of or inability to obtain adequate prevention, and limited or nonexistent access to specialists.

Joel Karlin, MD, a representative of the American Medical Association and one of the task force members, says that allergy management often begins with the primary care practitioner, who may not know how to identify and treat the entire spectrum of allergic diseases. In a typical eight-minute office visit, Karlin says, "it is utterly impossible to do an in-depth examination and diagnosis."

The guidelines are divided into three volumes. The first covers the allergic process and provides general principles of diagnosis and management. Volume 2 looks at asthma and allergies that affect the nose and sinuses, middle ear, and skin. Volume 3 covers conditions thought to have an allergic component, including reactions to food, insect bites, latex, and certain drugs, as well as hives and conjunctivitis, an inflammation of the eyes. The report can be found on the Internet at

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