Effect of allergen immunotherapy practice parameters on cat extract prescribing patterns, 1993-2009.
BACKGROUND
Cat extract allergen immunotherapy (AIT) is an effective treatment for cat allergy. The prescribed dose for cat AIT varies among prescribers, despite published data supporting an effective dose range. The original practice parameter published in December 1996 did not recommend a dose of cat allergen, but updates in January 2003 and September 2007 recommend cat extract dose ranges of 2,000 to 3,000 BAU and 1,000 to 4,000 BAU, respectively.


OBJECTIVE
To describe the prescribing patterns for cat AIT among practicing allergists in a large health care system and the effect of practice parameters on these patterns.


METHODS
A total of 27,788 prescriptions were analyzed to determine the date and amount of maintenance dose cat allergen prescribed. The data were subdivided into periods before and after the 3 published AIT practice parameters.


RESULTS
From January 2003 to September 2007, 1,810 prescriptions (18.0%) were written in the recommended range. From September 2007 to May 2009, 3,143 prescriptions (82.6%) were written in the recommended range. Cat AIT maintenance doses were 1,000 to 4,000 BAU 22.1% of the time before January 2003, 61.8% from January 2003 to September 2007, and 82.6% from September 2007 to May 2009.


CONCLUSIONS
In this large systemic evaluation of cat AIT prescribing patterns, maintenance dose recommendations in the AIT practice parameters were associated with changes in the prescribing patterns for cat AIT. Most prescriptions for cat AIT were inconsistent with recommended doses in the AIT practice parameters between 2003 and 2007. Dosing within recommended ranges improved after 2007, in part due to a widening of the recommended dose range.
Department of Allergy/Immunology, Walter Reed Army Medical Center, Washington, DC, USA. brian.robertson@amedd.army.mil
Brian D
BD
Robertson
Robert L
RL
McCoy
Michael R
MR
Nelson
Bret R
BR
Haymore
D000485:Allergens / Q000276:immunology / Q000627:therapeutic use*; D000818:Animals; D002415:Cats; D002457:Cell Extracts / Q000276:immunology / Q000627:therapeutic use*; D003888:Desensitization, Immunologic; D005500:Follow-Up Studies; D006801:Humans; D006967:Hypersensitivity / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000706:statistics & numerical data*
D000485:Allergens; D002457:Cell Extracts