|
|
 |
JACI Highlights - July 2008
Anaphylaxis management plans for the acute and long term management of anaphylaxis: a systematic review
Ulugbek Nurmatov, MD, PhD, Allison Worth, BSc (Hons), PhD, and Aziz Sheikh, MD, FRCP
Anaphylaxis is a severe allergic reaction that results in a life-threatening medical emergency. It can be brought on by any number of triggers. This condition is now responsible for growing numbers of consultations with family physicians, emergency room visits, hospitalizations, and deaths. To improve the outcomes of anaphylaxis episodes and, importantly, to reduce the risk of future episodes, anaphylaxis management plans (AMPs), similar to those advocated for asthma and other long-term conditions, are increasingly being recommended for use in the US, Europe, and Australia. However, a recent study found that there is no proven evidence from clinical studies to support the routine use of AMPs. In an analysis published in the Journal of Allergy and Clinical Immunology, Nurmatov et al reviewed the medical literature to determine whether there is data available to determine whether or not AMP use is helpful in managing anaphylaxis. From their review, the authors found that a number of AMPs exist and that other than agreeing on the central importance of early use of self-administered epinephrine (Epipens), there is no consensus on what should be included. The authors found that AMPs are acceptable to patients and caregivers and may considerably reduce the risk of occurrence, though this view could be biased. Access to specialists, problems with follow-up, and concerns about legal and financial liability of emergency epinephrine administration in schools were found to be barriers to the use of AMPs. Overall, the evidence to support use of self-management plans is encouraging but still weak compared to that for other long-term conditions such as asthma. Further studies need to evaluate the effectiveness and cost-effectiveness of AMPs and to develop standards for the components of care that should be included in an AMP.
<back>
|
