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TOPICS
Overview
Allergic bronchopulmonary aspergilllosis (ABPA)
Anaphylaxis - Updated
Asthma
Asthma Diagnosis
Environmental diagnosis
and management
Asthma Treatment:
Immunotherapy
Asthma Treatment:
Preventing Morbidity
- Updated
Asthma Treatment:
Preventing Mortality

- Updated
Asthma Treatment:
Adherence
Occupational Asthma
Conjunctivitis
Cough
Dermatitis
Atopic - Updated
Contact
Drug Allergy - Updated
Food Allergy - Updated
Hypersensitivity Pneumonitis
Insect Hypersensitivity
Occupational Diseases
Primary Immune Deficiency - Updated
Rhinitis/Rhinosinusitis
Rhinitis - Updated
Sinusitis
Urticaria/Angioedema - Updated
How the Allergist/Immunologist Can Help:
Consultation and Referral Guidelines Citing the Evidence

Disease Group: Asthma Treatment: Preventing Morbidity
  1. Patients with asthma who require Emergency Department care for acute episode
    [Rationale]
  2. Patients with uncontrolled asthma
    [Rationale]
  3. Patients with persistent asthma, particularly moderate-severe persistent asthma
    [Rationale]
  4. Patients who need education on asthma and guidance in techniques for self-management
    [Rationale]
  5. Patients who use excessive amounts of reliever medications
    [Rationale]
  6. Patients with severe asthma
    [Rationale]





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Allergist care reduces subsequent asthma emergency department visits. 1-10

Allergist care reduces subsequent hospitalization. 2-10
Direct outcome evidence
Allergist care reduces asthma symptoms and improves physical functioning and asthma-related quality of life. 1, 3, 11

Asthma specialist care is associated with improved asthma control.
Direct outcome evidence
Inhaled corticosteroid use leads to reduction in asthma symptoms, exacerbations, hospitalizations, and asthma death. 10

Allergist care is more likely to lead to use of asthma controller medications (particularly inhaled corticosteroids). 5, 7, 10-14


Allergists administer anti-IgE, which prevents exacerbations, improves pulmonary function, and reduces the use of inhaled steroids in patients with moderate-severe asthma. 15-16
Indirect outcome evidence
(controllers)

Indirect outcome evidence (anti-IgE)
Use of written action plans improves asthma self-management. 3, 13-14

Allergist care is more likely to lead to provision of a written management plan and objective monitoring of asthma using peak flow meters. 3, 13-14

Asthma self-management education improves outcomes in children and adults17,18

Allergist care is associated with more effective self-management education and knowledge 3,19,20.
Indirect outcome evidence (education, action plan)
Excessive short acting beta agonist use indicates uncontrolled asthma.
Allergist care reduces overuse of short acting beta agonists.13
Direct outcome evidence
Allergist care reduces cost of care for asthma. 6, 8-9, 21
Direct outcome evidence