Allergies, the educational imperative

Main Category: Respiratory / Asthma
Article Date: 01 Jun 2004 - 18:00 PDT

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Each year more than 50 million Americans suffer from allergic diseases, the sixth leading cause of chronic disease in the United States. The annual healthcare system cost is over $18 billion, according to the American Academy of Allergy, Asthma, and Immunology (AAAAI). Rhinitis, sinusitis, dermatitis, asthma, food allergy, and other allergic disorders can negatively impact quality of life and escalate healthcare costs.

Physicians agree that allergic diseases can be controlled and symptoms can be prevented or at least minimized. According to Stanley Goldstein, MD, FAAAAI, one of the biggest obstacles that primary care physicians face when treating patients with allergies is time constraints.

When assessing allergies, primary care physicians look at environmental control and medication management.

"One of the most difficult issues for primary care physicians when treating allergies is medication management. There are more medications that have been added to the armamentarium in recent years and determining the best and most appropriate medications for patients can be challenging. Physicians are forced to ask themselves 'Do I use these medications as needed or do I use them chronically? Do I give the patient inhaled medications or oral medications?' Other issues, such as the patient's age and the potential for adverse interactions, need to be addressed as well."

According to Dr. Goldstein, the availability of over-the-counter (OTC) antihistamines, decongestants, and cold and cough preparation have led many patients to self medicate their allergies. "Patients are treating themselves often without achieving adequate improvement and they fail to realize that they can actually feel better," says Dr. Goldstein.

"Patients continue to walk around with stuffiness and congestion, which can lead to difficulty in sleeping and falling asleep or concentrating throughout the day. These patients accept their allergy symptoms and figure that this is the way they're forced to live. When they attempt to self medicate, the results can lead to more problems."

Another problem when patients try to self medicate is that their efforts can be expensive. Dr. Goldstein says "The question comes down to what costs more - visiting a doctor to receive better treatment or self medicating? More often than not, self medicating can be an expensive option and will not improve the patient's condition. I've had patients visit me to treat their allergies after trying to self medicate and some have said 'if I only would've known that I could've felt this good, I would've come earlier.'"

Dr. Goldstein says another problem when patients try to self medicate is they often bounce from medication to medication. "There are a few basic ingredients in OTC cough and cold preparation medications. If manufacturers change a few ingredients, patients may think this is a great new medication. In reality, the different cough and cold preparation medications still have those same basic ingredients. If one product does not provide relief, many patients will move that product to another in a costly and generally ineffective self medication program. Too few allergy suffers seem to know that a physician is able to fully assess their condition and can offer very effective prevention strategies and prescription medications."

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