Allergen sensitization evaluation and allergen avoidance education in an inner-city adult cohort with persistent asthma

Paula J. Busse, Jason J. Wang, Ethan A. Halm

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Background: Asthma morbidity, mortality, and health services utilization are highest among inner-city populations. The National Asthma Education and Prevention Program Expert Panel recommends that all patients with moderate and severe persistent asthma be evaluated for sensitization to environmental allergens. Objective: This study examined whether a cohort of inner-city adults hospitalized with asthma had been evaluated for allergen sensitization, received avoidance counseling, and followed through on these recommendations. Methods: One hundred sixty-nine eligible patients who were part of a prospective cohort of all adults hospitalized in an inner-city hospital over a consecutive 12-month period completed a questionnaire to assess allergen sensitization evaluation, avoidance education, and adherence. Results: Overall, 60% of patients had ever been evaluated for allergen sensitization. Among those who were evaluated, 94.0% were sensitized to at least one antigen: 91.5% to dust mites, 90.5% to outdoor allergens, 77.9% to cats, 69.5% to dogs, 68.4% to molds, and 61% to cockroaches. Approximately half of the patients sensitized to dust mite (55.1%) or mold (52.8%) were given any avoidance-abatement advice. Patient adherence to this advice was highly variable. Allergen sensitization evaluation was more likely among women (odds ratio, 3.05; CI, 1.64-8.64) and those who use oral steroids most or all of the time (odds ratio, 7.14; CI, 2.25-22.56) and less likely among smokers (odds ratio, 0.26; CI, 0.11-0.61). Conclusion: In this population of inner-city adults hospitalized with asthma, the quality of allergen sensitization evaluation, avoidance education, and patient adherence with these recommendations was suboptimal.

Original languageEnglish (US)
Pages (from-to)146-152
Number of pages7
JournalJournal of Allergy and Clinical Immunology
Volume116
Issue number1
DOIs
StatePublished - Jul 2005

Fingerprint

Allergens
Asthma
Education
Mites
Odds Ratio
Patient Compliance
Dust
Fungi
Cockroaches
Urban Hospitals
Patient Education
Population
Health Services
Counseling
Cats
Steroids
Dogs
Morbidity
Antigens
Mortality

Keywords

  • Adult
  • Allergen evaluation
  • Asthma
  • Education

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Allergen sensitization evaluation and allergen avoidance education in an inner-city adult cohort with persistent asthma. / Busse, Paula J.; Wang, Jason J.; Halm, Ethan A.

In: Journal of Allergy and Clinical Immunology, Vol. 116, No. 1, 07.2005, p. 146-152.

Research output: Contribution to journalArticle

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abstract = "Background: Asthma morbidity, mortality, and health services utilization are highest among inner-city populations. The National Asthma Education and Prevention Program Expert Panel recommends that all patients with moderate and severe persistent asthma be evaluated for sensitization to environmental allergens. Objective: This study examined whether a cohort of inner-city adults hospitalized with asthma had been evaluated for allergen sensitization, received avoidance counseling, and followed through on these recommendations. Methods: One hundred sixty-nine eligible patients who were part of a prospective cohort of all adults hospitalized in an inner-city hospital over a consecutive 12-month period completed a questionnaire to assess allergen sensitization evaluation, avoidance education, and adherence. Results: Overall, 60{\%} of patients had ever been evaluated for allergen sensitization. Among those who were evaluated, 94.0{\%} were sensitized to at least one antigen: 91.5{\%} to dust mites, 90.5{\%} to outdoor allergens, 77.9{\%} to cats, 69.5{\%} to dogs, 68.4{\%} to molds, and 61{\%} to cockroaches. Approximately half of the patients sensitized to dust mite (55.1{\%}) or mold (52.8{\%}) were given any avoidance-abatement advice. Patient adherence to this advice was highly variable. Allergen sensitization evaluation was more likely among women (odds ratio, 3.05; CI, 1.64-8.64) and those who use oral steroids most or all of the time (odds ratio, 7.14; CI, 2.25-22.56) and less likely among smokers (odds ratio, 0.26; CI, 0.11-0.61). Conclusion: In this population of inner-city adults hospitalized with asthma, the quality of allergen sensitization evaluation, avoidance education, and patient adherence with these recommendations was suboptimal.",
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