Atopic conditions such as asthma, eczema, allergic rhinitis (hay fever) and food allergy commonly present in primary care. In the last few years we have seen tragic deaths from food allergies make the headlines, and we know that over 2% of children in the UK are affected by peanut allergy, with estimates of lifetime prevalence for any food allergy reaching around 20%. Allergic rhinitis is even more common, affecting up to 50% of the population worldwide; it is often seen as a mere summer inconvenience but is more significant than this, being associated with poorly controlled asthma and impaired performance in school exams and at work. The National Review of Asthma Deaths serves as a timely reminder that allergy is a key consideration in severe asthma, with trigger factors being recorded for under half of those featured in the report. Eczema also has a significant effect on quality of life; children with eczema are more likely to be bullied, to miss school, and to have poor school performance than their peers and are at a higher risk of depression than the general population.
The RCGP allergy hub provides a variety of resources to help learners to improve their knowledge on allergy. The eLearning course on allergy has four modules which between them cover all of the atopic conditions already discussed. A pre and post course MCQ allows users to test the improvement in their knowledge after doing the course.
There are also a variety of podcasts which cover different
aspects of the diagnosis and management of allergy in primary care,
particularly the difference between IgE mediated and non-IgE mediated allergy.
Non-IgE mediated allergy can be more difficult to diagnose, because symptoms
may present some time after the allergen was ingested, and may not be initially
recognised as being allergic in origin. The connection between asthma and
allergic rhinitis is discussed, using the concept of the one-airway theory.
Pollen food syndrome, otherwise known as oral allergy syndrome, is also the
subject of a podcast; whilst this allergy is usually mild and short lived, it
can cause anxiety if oral symptoms are incorrectly interpreted as the start of
a more sever reaction. In many of our courses and podcasts we attempt to do
some myth busting, so that patients can access accurate information from their
GPs, and any incorrect assumptions can be challenged. Finally, there are four
short screencasts which provide bite-sized updates for the time-pressed GP who
wants to know more about eczema, peanut allergy, asthma or allergic rhinitis.
References:
- https://cks.nice.org.uk/topics/food-allergy/
- https://cks.nice.org.uk/topics/allergic-rhinitis/
- https://cks.nice.org.uk/topics/eczema-atopic/
- Walker S, Khan-Wasti S, Fletcher M et al. Seasonal allergic rhinitis is associated with a detrimental effect on examination performance in United Kingdom teenagers: case-control study. J Allergy Clin Immunol. 2007 Aug;120(2):381-7.
- de la Hoz Caballer B, Rodríguez M, Fraj J, Cerecedo I, Antolín-Amérigo D, Colás C. Allergic rhinitis and its impact on work productivity in primary care practice and a comparison with other common diseases: the Cross-sectional study to evAluate work Productivity in allergic Rhinitis compared with other common dIseases (CAPRI) study. Am J Rhinol Allergy. 2012 Sep-Oct;26(5):390-4
- Royal College of Physicians. Why asthma still kills. May 2014. https://www.rcplondon.ac.uk/projects/outputs/why-asthma-still-kills
