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Leonard Bielory, Mark Dykewicz, Timothy Craig, Michael Blaiss, Bryan Leatherman, David Skoner, Nancy Smith, F. Allen-Ramey; Ophthalmology/Optometry Allergic Rhinoconjunctivitis Patient Treatment; The Allergies, Immunotherapy & RhinoconjunctivitiS (AIRS) Provider Survey. Invest. Ophthalmol. Vis. Sci. 2013;54(15):888.
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Allergic Rhinoconjunctivitis (ARC) is one of the most common chronic diseases in the US and specific immunotherapy (SIT) is one of the most effective therapies. The AIRS survey was designed to assess providers' perceptions of patient symptomatology, allergy testing and treatment.
A telephone survey was administered to 500 healthcare providers offering outpatient care to >1 ARC patient per week. Providers were randomly selected from professional society lists stratified by specialty to yield completed surveys from 100 Allergy/Immunology, 100 Otolaryngologists (ENTs), 75 Family Medicine, 75 Pediatrics and 50 Ophthalmology/Optometry providers along with 50 Nurse Practitioners (NP) and 50 Physician Assistants (PA).
Ophthalmology/Optometry (OPH/OPT) providers reported managing an average of 15 adult (≥18 years) and 6 pediatric (<18 years) ARC patients/ week; with the most common complaint reported being ocular symptoms. Sixty-two per cent watery or teary eyes,and 24% red eyes. Nasal symptoms were reported less frequently by all providers with 58% reporting nasal congestion, 35% runny nose, 27% repeated sneezing, 16% post-nasal drip, 12% nasal itching and 14% cough. All provider groups reported ocular symptoms more frequently than nasal symptoms, with the exception of ENT providers. In addition, OPH/OPT reported the most infrequent use of allergy diagnostic testing such as skin or blood tests at 4% of patients. OPH/ OPT reported similar severity of patients to that of other provider groups with 96% reporting at least a moderate amount of impact on their patients' quality of life (QOL). However, a sizeable proportion of OPH/OPT (14%) do not refer or provide specific immunotherapy (SIT), as compared to other provider groups (< 5%), although 70% of OPH/OPT believed that SIT was more efficacious than symptomatic medications.
Eye care specialists commonly see patients with ARC and appreciate the benefits of immunotherapy. As compared to some other provider groups, eye care specialists perform allergy testing infrequently and are less likely to recommend SIT or refer unresponsive patients to another healthcare provider. Education of ophthalmologists/optometrists on effectiveness of immunotherapy may improve patient outcomes since SIT alleviates all symptoms of ARC including ocular symptoms.
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