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National Survey of United Kingdom Paediatric Allergy Services

BACKGROUND: Comprehensive national assessments of paediatric allergy services are rarely undertaken, and have never been undertaken in the United Kingdom. A 2006 survey estimated national capacity at 30,000 adult or paediatric new allergy appointments per year and identified 58 hospital clinics offe...

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Autores principales: Wells, Rosy, McKay, Cathy, Makwana, Nick, Vyas, Deepan, Vaughan, Sophie, Christopher, Anne, Thomas, Lucy, Primett, Misbah, Diwakar, Lavanya, Alvis, Shamir, Perkin, Michael R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9804618/
https://www.ncbi.nlm.nih.gov/pubmed/35920077
http://dx.doi.org/10.1111/cea.14198
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author Wells, Rosy
McKay, Cathy
Makwana, Nick
Vyas, Deepan
Vaughan, Sophie
Christopher, Anne
Thomas, Lucy
Primett, Misbah
Diwakar, Lavanya
Alvis, Shamir
Perkin, Michael R.
author_facet Wells, Rosy
McKay, Cathy
Makwana, Nick
Vyas, Deepan
Vaughan, Sophie
Christopher, Anne
Thomas, Lucy
Primett, Misbah
Diwakar, Lavanya
Alvis, Shamir
Perkin, Michael R.
author_sort Wells, Rosy
collection PubMed
description BACKGROUND: Comprehensive national assessments of paediatric allergy services are rarely undertaken, and have never been undertaken in the United Kingdom. A 2006 survey estimated national capacity at 30,000 adult or paediatric new allergy appointments per year and identified 58 hospital clinics offering a paediatric allergy service. OBJECTIVE: The UK Paediatric Allergy Services Survey was the first comprehensive assessment of UK paediatric allergy service provision. METHODS: All 450 UK hospitals responded to a survey. Paediatric allergy services are provided in 154 lead hospitals with 75 further linked hospitals. All 154 lead paediatric allergy services completed a detailed questionnaire between February 2019 and May 2020. RESULTS: The 154 paediatric allergy services self‐define as secondary (126/154, 82%) or tertiary (28/154, 18%) level services. The annual capacity is 85,600 new and 111,400 follow‐up appointments. Fifty‐eight percent (85/146) of services offer ≤10 new appointments per week (no data provided from 8 services—2 no response, 6 unknown) and 50% (70/139) of the services undertaking challenges undertake ≤2 food or drug challenges per week (no data from 3 challenge services). Intramuscular adrenaline is rarely used during challenges—median annual frequency 0 in secondary services and 2 in tertiary services. Allergen‐specific immunotherapy is offered in 39% (60/154) of services, with 71% (41/58) of these centres treating ≤10 patients per annum (no data from 2 immunotherapy services). The 12 largest services see 31% of all new paediatric allergy appointments, undertake 51% of new immunotherapy patient provision and 33% of food or drug challenges. Seventy percent (97/126) of secondary and all tertiary services are part of a regional paediatric allergy network. Only nine services offer immunotherapy for any food (3 for peanut), 10 drug desensitization and 18 insect venom immunotherapy. CONCLUSIONS: There has been a fourfold increase in paediatric allergy clinics and an approximately sevenfold increase in new patient appointment numbers in the United Kingdom over the past 15 years. Most services are small, with significant regional variation in availability of specific services such as allergen immunotherapy. Our findings emphasize the need for national standards, local networks and simulation training to ensure consistent and safe service provision.
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spelling pubmed-98046182023-01-03 National Survey of United Kingdom Paediatric Allergy Services Wells, Rosy McKay, Cathy Makwana, Nick Vyas, Deepan Vaughan, Sophie Christopher, Anne Thomas, Lucy Primett, Misbah Diwakar, Lavanya Alvis, Shamir Perkin, Michael R. Clin Exp Allergy Original Articles BACKGROUND: Comprehensive national assessments of paediatric allergy services are rarely undertaken, and have never been undertaken in the United Kingdom. A 2006 survey estimated national capacity at 30,000 adult or paediatric new allergy appointments per year and identified 58 hospital clinics offering a paediatric allergy service. OBJECTIVE: The UK Paediatric Allergy Services Survey was the first comprehensive assessment of UK paediatric allergy service provision. METHODS: All 450 UK hospitals responded to a survey. Paediatric allergy services are provided in 154 lead hospitals with 75 further linked hospitals. All 154 lead paediatric allergy services completed a detailed questionnaire between February 2019 and May 2020. RESULTS: The 154 paediatric allergy services self‐define as secondary (126/154, 82%) or tertiary (28/154, 18%) level services. The annual capacity is 85,600 new and 111,400 follow‐up appointments. Fifty‐eight percent (85/146) of services offer ≤10 new appointments per week (no data provided from 8 services—2 no response, 6 unknown) and 50% (70/139) of the services undertaking challenges undertake ≤2 food or drug challenges per week (no data from 3 challenge services). Intramuscular adrenaline is rarely used during challenges—median annual frequency 0 in secondary services and 2 in tertiary services. Allergen‐specific immunotherapy is offered in 39% (60/154) of services, with 71% (41/58) of these centres treating ≤10 patients per annum (no data from 2 immunotherapy services). The 12 largest services see 31% of all new paediatric allergy appointments, undertake 51% of new immunotherapy patient provision and 33% of food or drug challenges. Seventy percent (97/126) of secondary and all tertiary services are part of a regional paediatric allergy network. Only nine services offer immunotherapy for any food (3 for peanut), 10 drug desensitization and 18 insect venom immunotherapy. CONCLUSIONS: There has been a fourfold increase in paediatric allergy clinics and an approximately sevenfold increase in new patient appointment numbers in the United Kingdom over the past 15 years. Most services are small, with significant regional variation in availability of specific services such as allergen immunotherapy. Our findings emphasize the need for national standards, local networks and simulation training to ensure consistent and safe service provision. John Wiley and Sons Inc. 2022-08-03 2022-11 /pmc/articles/PMC9804618/ /pubmed/35920077 http://dx.doi.org/10.1111/cea.14198 Text en © 2022 The Authors. Clinical & Experimental Allergy published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Wells, Rosy
McKay, Cathy
Makwana, Nick
Vyas, Deepan
Vaughan, Sophie
Christopher, Anne
Thomas, Lucy
Primett, Misbah
Diwakar, Lavanya
Alvis, Shamir
Perkin, Michael R.
National Survey of United Kingdom Paediatric Allergy Services
title National Survey of United Kingdom Paediatric Allergy Services
title_full National Survey of United Kingdom Paediatric Allergy Services
title_fullStr National Survey of United Kingdom Paediatric Allergy Services
title_full_unstemmed National Survey of United Kingdom Paediatric Allergy Services
title_short National Survey of United Kingdom Paediatric Allergy Services
title_sort national survey of united kingdom paediatric allergy services
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9804618/
https://www.ncbi.nlm.nih.gov/pubmed/35920077
http://dx.doi.org/10.1111/cea.14198
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