Development of an allergy management support system in primary care
| Autor: | Jantina L. van der Velde, Janwillem W. H. Kocks, E. M. Roerdink, Bertine Flokstra de Blok, Joanne N.G. Oude Elberink, Marielouise Schuttelaar, Richard L Oei, Thecla M. Brakel, Thys van der Molen, W.A. Christoffers, Anthony E.J. Dubois |
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| Přispěvatelé: | Groningen Research Institute for Asthma and COPD (GRIAC), Public Health Research (PHR) |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Allergy Pediatrics diagnosis Population primary care 03 medical and health sciences 0302 clinical medicine Food allergy Journal Article Journal of Asthma and Allergy Immunology and Allergy Medicine management support system 030212 general & internal medicine education development Original Research Asthma Multiple choice education.field_of_study business.industry Gold standard Atopic dermatitis allergy medicine.disease 030228 respiratory system Family medicine Allergists business |
| Zdroj: | Journal of asthma and allergy, 10, 57-65. DOVE MEDICAL PRESS LTD Journal of Asthma and Allergy |
| ISSN: | 1178-6965 |
| Popis: | Bertine MJ Flokstra - deBlok,1,2 Thys van der Molen,1,2 Wianda A Christoffers,3 Janwillem WH Kocks,1,2 Richard L Oei,4 Joanne NG Oude Elberink,2,4 Emmy M Roerdink,5 Marie Louise Schuttelaar,3 Jantina L van der Velde,1,2 Thecla M Brakel,1,6 Anthony EJ Dubois2,5 1Department of General Practice, 2GRIAC Research Institute, 3Department of Dermatology, 4Department of Allergology, 5Department of Pediatric Pulmonology and Pediatric Allergy, University of Groningen, University Medical Center Groningen, 6Teaching Unit, Department of Social Psychology, University of Groningen, Groningen, The Netherlands Background: Management of allergic patients in the population is becoming more difficult because of increases in both complexity and prevalence. Although general practitioners (GPs) are expected to play an important role in the care of allergic patients, they often feel ill-equipped for this task. Therefore, the aim of this study was to develop an allergy management support system (AMSS) for primary care. Methods: Through literature review, interviewing and testing in secondary and primary care patients, an allergy history questionnaire was constructed by allergists, dermatologists, GPs and researchers based on primary care and specialists’ allergy guidelines and their clinical knowledge. Patterns of AMSS questionnaire responses and specific immunoglobulin E (sIgE)-test outcomes were used to identify diagnostic categories and develop corresponding management recommendations. Validity of the AMSS was investigated by comparing specialist (gold standard) and AMSS diagnostic categories. Results: The two-page patient-completed AMSS questionnaire consists of 12 (mainly) multiple choice questions on symptoms, triggers, severity and medication. Based on the AMSS questionnaires and sIgE-test outcome of 118 patients, approximately 150 diagnostic categories of allergic rhinitis, asthma, atopic dermatitis, anaphylaxis, food allergy, hymenoptera allergy and other allergies were identified, and the corresponding management recommendations were formulated. The agreement between the allergy specialists’ assessments and the AMSS was 69.2% (CI 67.2–71.2). Conclusion: Using a systematic approach, it was possible to develop an AMSS that allows for the formulation of diagnostic and management recommendations for GPs managing allergic patients. The AMSS thus holds promise for the improvement of the quality of primary care for this increasing group of patients. Keywords: allergy, development, diagnosis, management support system, primary care |
| Databáze: | OpenAIRE |
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