Adults with moderate and severe asthma may not have received optimal
evaluation to determine if they were allergic to indoor allergens.
Allergy and exposure to several indoor allergens like cockroach, dust
mite, molds and pets can play an important role in the worsening of
asthma.
Previous studies have demonstrated that avoidance to these common indoor
allergens in asthmatic patients can improve their asthma symptoms. In
addition, inner-city populations tend to suffer from higher rates of
asthma. Therefore, the National Institutes of Health asthma treatment
guidelines recommend that patients with moderate to severe asthma should
be evaluated for an allergic component to their asthma. In a paper
published by Paula Busse, MD, and Ethan Halm, MD, MPH, in a recent issue
of the Journal of Allergy and Clinical Immunology, a cohort of
169 adult patients from an inner-city population who were hospitalized
with asthma were interviewed. Most of these patients had a history of
frequent emergency department visits and hospitalizations for their
asthma, and 82 percent had a regular source of asthma care.
This study found that, despite their high burden of disease, only 60
percent of the patients had been evaluated for allergies to common
indoor allergens. Among those who were evaluated, 94 percent were
sensitized to a least one common indoor antigen. Approximately one-half
of the patients who were allergic to dust mites or mold recalled being
instructed by their medical provider on how to reduce the dust mite or
mold exposure. Even fewer of the patients who were counseled on allergen
avoidance measures completed them. This study suggests that adult
patients with persistent asthma from inner-city populations are not
being optimally evaluated and counseled for their allergies to indoor
allergens, a factor which may be playing a role in their high rates of
asthma symptoms and hospitalizations. In addition, these patients were
not being routinely followed by a specialist in asthma. The authors
recommend that patients with persistent asthma be seen not only by a
general medicine practice, but also by specialists in asthma and allergy.
Source: Mount Sinai
Medical Center
