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Pragmatic randomized controlled trial of a structured allergy intervention for adults with asthma and rhinitis in general practice

journal contribution
posted on 2023-06-08, 20:20 authored by Helen Smith, Deborah Horney, Stephanie Goubet, Christina Jones, Abid Raza, Peter White, Anthony Frew
Background: It is widely believed that in patients with allergic rhinitis and asthma, avoidance of specific triggers can help improve symptom control and reduce need for medication. Whilst most patients with asthma or rhinitis are sensitized to airborne allergens, primary care diagnostic and management decisions are often made without either obtaining a detailed history of the patient's allergic triggers or performing skin prick tests. Thus, management decisions are empirical and allergen avoidance advice is either not given or, if given, not tailored to the patient's sensitivities. Method: To ascertain whether allergy assessment and tailored advice in general practice for patients with asthma and rhinitis enhance well-being, we conducted a pragmatic, open, randomized controlled trial of allergy intervention (structured allergy history and skin prick testing and appropriate advice on allergy avoidance) versus usual care in adult patients with a working diagnosis of asthma and/or rhino-conjunctivitis. Outcomes were assessed after 12 months by an observer who was blinded to allocation. The main outcome measures were asthma and rhinitis symptoms, disease-specific health-related quality of life, generic quality of life and lung function. Results: There were no significant differences in baseline demographics or disease characteristics between patients assigned to immediate or delayed skin prick testing. No significant differences were observed between groups for any measures of symptoms, quality of life or lung function at 12 months (all P > 0.05). Conclusion: Amongst adults with known asthma and/or rhinitis in primary care, taking a structured allergy history with skin prick tests and giving tailored advice on allergy avoidance made no difference to their symptoms, quality of life or lung function as measured twelve months later.

History

Publication status

  • Published

File Version

  • Published version

Journal

Allergy

ISSN

0105-4538

Publisher

Blackwell Publishing

Issue

2

Volume

70

Page range

203-211

Department affiliated with

  • Division of Medical Education Publications

Full text available

  • No

Peer reviewed?

  • Yes

Legacy Posted Date

2015-03-16

First Compliant Deposit (FCD) Date

2015-03-16

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