Development of an allergy management support system in primary care
Development of an allergy management support system in primary care
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DOI：
10.2147/jaa.s123260
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发表时间：
2017-01-01
影响因子：
3.2
通讯作者：
Dubois, Anthony E. J.
中科院分区：
文献类型：
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作者：
Flokstra-de Blok, Bertine M. J.;van der Molen, Thys;Dubois, Anthony E. J.
背景：由于复杂性和患病率的增加，人群中过敏患者的管理变得越来越困难。虽然全科医生（全科医生）预计将发挥重要作用，在过敏性患者的护理，他们往往感到装备不良，这项任务。因此，本研究的目的是开发一个过敏管理支持系统（AMSS）的初级care.Methods：通过文献回顾，在二级和初级保健患者的访谈和测试，过敏史问卷由过敏症专科医生，皮肤科医生，全科医生和研究人员的基础上初级保健和专家的过敏指南和他们的临床知识。AMSS问卷回答和特异性免疫球蛋白E（sIgE）检测结果的模式被用来确定诊断类别，并制定相应的管理建议。AMSS的有效性进行了调查，通过比较专家（金标准）和AMSS诊断category.Results：两页的患者完成的AMSS问卷包括12个（主要）多项选择题的症状，触发器，严重程度和药物。根据118例患者的AMSS问卷和sIgE检测结果，确定了过敏性鼻炎、哮喘、特应性皮炎、过敏反应、食物过敏、过敏性鼻炎和其他过敏的约150个诊断类别，并制定了相应的管理建议。过敏专家的评估和AMSS之间的协议是69.2%（CI 67.2-71.2）。结论：使用系统的方法，它是可能的AMSS，允许制定诊断和管理建议的GP管理过敏患者。因此，AMSS有望提高这一日益增多的患者群体的初级保健质量。
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.