How to improve diagnosis and treatment of allergy
Step it up in education, diagnostics, and therapy
If you think more allergy patients are landing in your chair every year, you’re absolutely correct. The prevalence of allergy is rising worldwide to near epidemic proportions and carries a significant burden for both the individual patient as well as healthcare systems globally.
Astoundingly in 2012, over 17 million adults and 6.6 million children in the United States were diagnosed with allergic rhinitis, and 11.1 million medical examinations were performed resulting in a primary diagnosis of allergic rhinitis (AR).1 Ocular manifestations of allergy-like conjunctivitis are among the comorbidities of AR, and the prevalence of ocular allergy is increasing. The World Allergy Organization (WAO) reports that allergic conjunctivitis carries with same “clinical gravity as allergic asthma and allergic rhinitis.”2
More allergy: A new player in point-of-care allergy testing
Poor allergy diagnosis and treatment
In spite of the overwhelming statistics, allergy often goes undiagnosed and untreated. Many physicians and patients consider the condition to be more of an annoyance and aggravation than a chronic and potentially progressive, and in some cases, life-threatening disease. However, “it’s just my allergies acting up” affects the patient’s ability to live, work, and play, and costs just under $8 billion annually in the United States.3
Unfortunately, doctors are falling short. They often fail to properly diagnose and educate patients on the allergic conditions, but perhaps the greatest shortfall is they assume their patients are satisfied with the care and treatment they have been given. Allergy patients tend to suffer in silence, dripping and sniffing in cubicles and classrooms across the country. Doctors, mistakenly, assume that because a patient doesn’t return after a prescription has been written that he is satisfied, but this isn’t necessarily the case. Some patients fail to find relief because the drug prescribed is ineffective or loses efficacy throughout the day. They may also be burdened by high cost or unwelcome side effects. Many allergy patients have little faith that a “cure” is available, so they just don’t return to the doctor or, worse yet, bounce from practitioner to practitioner.3
More from Dr. Hauser: 5 things you don't know about punctal plugs
The WAO identifies the need for increased training of a doctors focusing on properly caring for patients with allergic disease.2 Gatekeepers like primary eyecare providers are essential in identifying and treating the majority of patients with ocular sequelae. The sheer volume of patients necessitates that providers across the board, not just specialists, must play a role. Allergists are indispensable partners in caring for these patients. Developing an interdisciplinary approach will best serve patients and keep specialist waiting rooms from overflowing with easily managed cases.
If many doctors are making the grade, where can improvements be made?