Case Report: Allergic Rhinitis (AR)

Learning Objectives:

1. ) Better understand the seasonal and perennial allergies that Louisianans face, particularly in the summer.
2. ) Learn more about allergy treatment options in the family practice setting.
3. ) Understand the need for primary care providers to provide allergy care.Draft Article:

Allergic Rhinitis (AR) is the fifth leading cause of chronic disease among all Americans1 and a major concern for Louisianans year round. As many as 30 percent of all adults and 40 percent of children suffer from AR nationwide.2 In Louisiana in particular, the humid weather often causes patients to experience more severe symptoms than in other parts of the country. While in other areas summertime is often associated with reduced pollen counts and allergy symptoms, Louisiana’s hot humid, summers foster spikes in mold, grasses and other airborne allergens.

Routinely dismissed as a minor nuisance rather than a serious health problem, AR can actually be a significant hindrance. In 2010 alone, Americans suffering from AR spent approximately $17.5 billion on allergy treatments (such as over-the counter and prescription medication), lost more than six million work and school days and made 16 million visits to the doctor.3 The demand for allergy treatment is projected to increase by 35 percent by 2020, while the number of allergists in the U. S. is expected to decline by 6.8 percent by the same year.4 With this disparity, it is impossible for all patients suffering from seasonal and perennial allergies to be adequately treated by an allergist. Until recently, family physicians like me had limited ability to effectively treat patients with allergies. When patients presented with AR symptoms, my typical course of action was to prescribe medications to alleviate their symptoms, but did not have the ability to determine the exact cause of their allergies or treat the cause, using allergen immunotherapy. In other cases, I would refer my patients to an outside allergist to receive allergy testing and immunotherapy. Making these appointments often required that my patients wait months to make an appointment, drive long distances or take too much time away from work or school, which prevented many of them from receiving needed care.

By working with a health care services company called United Allergy Services, I am now able to offer my patients lasting, disease modifying relief from perennial and seasonal allergies with immunotherapy, which induces immunologic tolerance by administering safely increased doses of an allergen.5 Immunotherapy has been used for over 100 years and proven as the gold standard for effective treatment of AR and can also prevent the onset of new allergies and allergic asthma.6

By working with United Allergy Services, over 85,000 patients have safely received immunotherapy from family physicians across the country. This record of safe subcutaneous immunotherapy is demonstrated by the disparity in occurrence of adverse systemic reactions to immunotherapy for board certified allergists (4 to 7%) and physicians working with UAS (0.18%).

Allergy sufferers in Louisiana and throughout the U.S. are in need of effective and long lasting treatment for seasonal and perennial allergies. There are simply not enough allergy specialists to treat the number of patients requiring effective treatment. Primary care physicians like me are in an ideal position to help our patients find long-lasting relief from allergy symptoms.

(Endnotes)

1 “Chronic Conditions: A Challenge for the 21st Century,” National Academy on an Aging Society, 2000

2 “Chronic Conditions: A Challenge for the 21st Century,” National Academy on an Aging Society, 2000

3 Lindner, Melanie. “When Allergies Attack.”Fortune 26 July 2010.

4 Allergist report.(n.d.). Retrieved from http://www.acaai.org/press/ Documents/AllergistReport08Final.pdf

5 Immunotherapy can provide lasting relief. February 2011. Retrieved from http://www.aaaai.org/Aaaai/media/ MediaLibrary/PDF%20Documents/ Libraries/immunotherapy-historypatient.Pdf

6 Airborne allergens: Something in the air. National Institute of Allergy and Infectious Diseases. NIH Publication No. 03-7045. 2003.

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Dr. Tamika Mayo, MD
epubs.democratprinting.com