Reasons for outpatient consultation in allergy/immunology

Abstract

There is little data in the literature regarding outpatient consultation in allergy/immunology (A/I). The purpose of this study was to determine the relative frequency of different reasons for A/I outpatient consultation to help guide graduate medical education (GME) and assist with A/I practice management. We retrospectively reviewed the electronic medical records of all outpatient A/I consultations from January 1, 2006 to December 31, 2006. The study was performed at our tertiary care referral center which is a GME training site. There were 1412 A/I consults requested during the 1-year period. The consults per month ranged from a low of 69 to a high of 157. The referrals consisted of 35% pediatric and 65% adult patients. There were 52.8% female and 47.2% male patients. We received 74.3% of referrals from primary care, 19.8% from specialty care, and 5.9% from the emergency department. The most common reasons for consultation included 808 (57.2%) patients for chronic rhinitis, 288 (20.4%) for asthma, 196 (13.9%) for food allergy, 89 (6.3%) for venom allergy, 68 (4.8%) for atopic dermatitis, 66 (4.7%) for drug allergy, 62 (4.4%) for chronic urticaria, 45 (3.2%) for acute urticaria, 34 (2.4%) for immunodeficiency, 31 (2.2%) for anaphylaxis, and 162 (11.5%) for other reasons. More than one reason was given for 27.1% of consults, and there was an average of 1.3 reasons for consultation per patient. Although the allergist/immunologist is consulted for a variety of reasons, the top three reasons make up a majority of outpatient consults, and consults are often requested to address more than one diagnosis.

Synchronous telehealth for outpatient allergy consultations

“…In contrast, TeleAllergy consultation for asthma was significantly lower (4.1% vs 20.4%), whereas referral for urticaria was 4-folder higher (16% vs 4.4%). 11 It is unknown why referrals for asthma were lower than expected compared with other referral reasons. One possibility is that the 85% of all regional telehealth involved adults (unpublished data), and these patients could have been referred to the pulmonologist rather than allergist.…”

Epidemiology and risk factors for drug allergy

“…Dietrich et al [39] followed up with a review of allergy/immunology consults in the same US centre from January to December 2006. A total of 1412 outpatient paediatric and adult consults were requested of which 4.7% were for suspected drug allergy.…”

Outcomes and safety of drug provocation tests

“…5 There have been few studies investigating DPTs, considering that drug allergy is one of the most common reasons for consultation in allergy/immunology. 8,9 Therefore, the objective of the present study was to describe DPT results in patients with a history suggestive of hypersensitivity, as well as to address issues related to the safety of the tests, risks of severe reactions, and treatment of the reactions observed.…”