Diagnosis and treatment of nasal and ocular allergies: the Allergies, Immunotherapy, and RhinoconjunctivitiS (AIRS) surveys

Blaiss, Michael S.; Dykewicz, Mark S.; Skoner, David P.; Smith, Nancy E.; Leatherman, Bryan; Craig, Timothy J.; Bielory, Leonard; Walstein, Nicole; Allen‐Ramey, Felicia

doi:10.1016/j.anai.2014.02.006

Cited by 30 publications

(32 citation statements)

References 11 publications

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“…In The Allergies, Immunotherapy, and Rhinoconjunctivitis Survey (AIRS) performed in the US questioning health care providers who prescribe primarily SCIT, found that only about a third completed three years of immunotherapy [87]. A retrospective review evaluated US veterans' adherence to SCIT over a 10-year period [88].…”

Section: Adherence and Cost Issues: Scit Versus Slitmentioning

confidence: 99%

Selection of Patients for Sublingual Versus Subcutaneous Immunotherapy

Larenas‐Linnemann

Blaiss

2014

Immunotherapy

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Allergen immunotherapy is the sole treatment for IgE-mediated allergic diseases directed at the underlying mechanism. The two widely accepted administration routes are sublingual (SLIT) and subcutaneous (SCIT). We reviewed how patients should best be selected for immunotherapy and how the optimal administration route can be defined. Before deciding SCIT or SLIT, appropriate selection of patients for allergen immunotherapy (AIT) is mandatory. To be eligible for AIT, subjects must have a clear medical history of allergic disease, with exacerbation of symptoms on exposure to one or more allergens and a corresponding positive skin or in vitro test. Then the route of administration should be based on: published evidence of clinical and immunologic efficacy (which varies per allergic disease and per allergen); mono-or multi-allergen immunotherapy, for SLIT multi-allergen immunotherapy was not effective; safety: adverse events with SLIT are more frequent, but less severe; and, costs and patient preferences, closely related to adherence issues. All these are discussed in the article.

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Section: Adherence and Cost Issues: Scit Versus Slitmentioning

confidence: 99%

Selection of Patients for Sublingual Versus Subcutaneous Immunotherapy

Larenas‐Linnemann

Blaiss

2014

Immunotherapy

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“…In 2014, the Allergies, Immunotherapy, and Rhinoconjunctivitis (AIRS) surveys concluded that depending on the specialty, the percentage of allergic rhinoconjunctivitis patients receiving AIT ranged from 7% to 33%. Amongst the adult patients, allergists/immunologists reported that 33% were undergoing AIT compared to the 25% reported by otolaryngologists . Not surprisingly, otolaryngologists share the role in provision of AIT with allergists/immunologists.…”

Section: Discussionmentioning

confidence: 74%

Evolving patterns in the diagnosis and management of allergy‐mediated disorders

Arianpour

Svider

Yuhan

et al. 2018

Int Forum Allergy Rhinol

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Physicians have been more aggressive in the workup of allergy-mediated disorders in recent years. Although differences in allergen load exist, there is tremendous geographic variation in the ratio of testing to immunotherapy. While the role otolaryngologists play in immunotherapy remains stable, allergists manage the majority of patients, reinforcing the importance of interdisciplinary cooperation and outreach. SLIT does not appear to play a significant role in this population.

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“…A lack of training in immunotherapy was the most common reason otolaryngologists and other physician specialties cited for not offering AIT—except for allergist/immunologists, who most often cited cost. While 95% of allergist/immunologists conducted an allergy test in office when diagnosing ARC, only 63% of otolaryngologists and 28% to 39% of the other physician specialties did so . Otolaryngologists who did conduct allergy tests in‐office when diagnosing ARC also provided immunotherapy in‐office.…”

Section: Discussionmentioning

confidence: 99%

“…The AIRS provider survey design is described in detail elsewhere . Healthcare providers were randomly selected from the American Medical Association (AMA) Master List and from national lists of optometrists, nurse practitioners, and physician assistants, and interviewed by telephone between February and May in 2012.…”

Section: Methodsmentioning

confidence: 99%

The Allergies, Immunotherapy, and RhinoconjunctivitiS (AIRS) survey: provider practices and beliefs about allergen immunotherapy

Leatherman¹,

Skoner

Hadley³

et al. 2014

Int Forum Allergy Rhinol

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Background The practices and beliefs of the provider specialties that treat allergic rhinoconjunctivitis (ARC) with allergen immunotherapy (AIT) may vary. Methods A telephone survey of 500 randomly selected health care practitioners in 7 specialties, conducted in 2012. Results AIT was provided as a subcutaneous injection (SCIT) by 91% of allergist/immunologists, 54% of otolaryngologists, and 18% to 24% of other specialties. Otolaryngologists were the most frequent providers of sublingual drops of AIT (SLIT; 33%), compared to 2% to 10% of other specialties. AIT was recommended for adults with allergic rhinoconjunctivitis by 100% of allergist/immunologists vs 62% to 84% of the other specialties (p < 0.001). The primary reason for recommending AIT for adults (52%) or children (46%) was that other therapies did not work. Between 48% (nurse practitioners/physician assistants) and 93% (allergist/immunologists) of practitioners always or often decreased symptomatic medications over the course of AIT treatment. Most practitioners in all specialties (82–100%) thought that AIT was appropriate for patients with severe allergy symptoms. Significantly more allergist/immunologists and otolaryngologists than other specialists thought AIT was appropriate for mild allergy symptoms (p < 0.001 and p = 0.004, respectively, vs other specialties). Significantly more allergist/immunologists than other specialists thought that AIT was more effective than symptomatic medications (p < 0.001), could reduce the further development of allergies (p = 0.03), and could prevent the development of asthma. Conclusion SCIT was more frequently provided than SLIT by all the specialties. Otolaryngologists were the most likely to offer SLIT, while very few allergist/immunologists offered SLIT. Allergist/immunologists differed from other specialties in some beliefs about the effectiveness of AIT.

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Diagnosis and treatment of nasal and ocular allergies: the Allergies, Immunotherapy, and RhinoconjunctivitiS (AIRS) surveys

Cited by 30 publications

References 11 publications

Selection of Patients for Sublingual Versus Subcutaneous Immunotherapy

Selection of Patients for Sublingual Versus Subcutaneous Immunotherapy

Evolving patterns in the diagnosis and management of allergy‐mediated disorders

The Allergies, Immunotherapy, and RhinoconjunctivitiS (AIRS) survey: provider practices and beliefs about allergen immunotherapy

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