Delivery of asthma and allergy care in Europe.
BACKGROUND
There is no comprehensive information available concerning the way in which care is provided for those with allergic conditions in Europe.


OBJECTIVE
To determine who cares for those with asthma, allergic dermatitis, and rhinitis in Europe and to determine the involvement of primary care and other healthcare professionals and the use of patient education and guidelines.


METHODS
A questionnaire survey of colleagues in 43 institutions in 33 European countries with results being related to published sources of information regarding prevalence of allergic diseases in different countries and published data regarding availability of doctors and expenditure on healthcare.


RESULTS
A total of 33 of 43 institutions completed the survey (76.7%) with information being obtained from 26 of the 33 countries surveyed (78.7%). There are wide differences in the use of different healthcare professionals in different countries, with those for asthma, for example, being most likely to be cared for by an allergologist in some countries and by a primary care physician in many others. There was much greater awareness of guidelines for asthma and little reported usage of guidelines in the management of those with allergic skin diseases, and while self-management education was offered most to those with asthma, there was a wide variation in the usage of group education.


CONCLUSIONS
Many of the differences revealed by this survey cannot be explained by the availability of different healthcare professionals nor by differences in healthcare expenditure, and such differences need further evaluation to determine their effect on outcomes and the economics of healthcare so that we may determine that which is optimal.
Allergy Department, National & Kapodistrian University of Athens, Greece. nicola.roberts@imperial.ac.uk
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Roberts
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Papageorgiou
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Partridge
D000486:Allergy and Immunology; D001249:Asthma / Q000628:therapy*; D017449:Dermatitis, Allergic Contact / Q000628:therapy*; D005060:Europe; D017408:Guidelines as Topic; D006282:Health Personnel; D006801:Humans; D010353:Patient Education as Topic; D012220:Rhinitis / Q000628:therapy*; D011795:Surveys and Questionnaires