title: Anaphylaxis challenges on the front line: perspectives from community medicine.
abstract: This report reflects a discussion from the multidisciplinary Partnership for Anaphylaxis Round Table meeting, held in November 2012, in Dallas, Texas. Community medicine participants included John R. Bennett, MD, an internist who practiced in Cumming, Georgia, and whose patients were adults; Leonard Fromer, MD, a family practitioner in Los Angeles, California, who was the medical director of a network of 600 medical groups, including pediatricians, internists, and family physicians, and who in his previous practice treated children and adults, many of them with severe allergies; and Mary Lou Hayden, MS, RN, FNP-BC, AE-C, a nurse practitioner who treated adults in a university employee health clinic and in an allergy clinic in Charlottesville, Virginia, and whose prior practice focused on allergy and immunology in children and adults. This discussion was moderated by Dr Bennett. Participants provided their perspectives as primary care providers (PCPs) concerning anaphylaxis, which has become a major public health concern. The rising prevalence of severe allergies and incidence of anaphylaxis and other severe allergic reactions among children and adults is shifting more care to PCPs. This discussion provides insights into challenges faced by PCPs in treating patients at risk for anaphylaxis in the community setting and provides potential solutions to those challenges.
authors.affiliation: Cumming Internal Medicine, Cumming, Ga. Electronic address: jrb1003@hotmail.com.
authors.forename: John R
authors.initials: JR
authors.lastname: Bennett
authors.affiliation: University of California at Los Angeles, Los Angeles, Calif.
authors.forename: Leonard
authors.initials: L
authors.lastname: Fromer
authors.affiliation: University of Virginia, Charlottesville, Va.
authors.forename: Mary Lou
authors.initials: ML
authors.lastname: Hayden
mesh_terms: D000707:Anaphylaxis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D002140:California / Q000453:epidemiology; D003154:Community Medicine / Q000592:standards / Q000639:trends; D015897:Comorbidity; D004638:Emergency Treatment / Q000379:methods* / Q000592:standards; D004837:Epinephrine / Q000008:administration & dosage*; D005194:Family Practice / Q000592:standards / Q000639:trends; D006801:Humans; D015994:Incidence; D007273:Injections, Intramuscular / Q000295:instrumentation; D010349:Patient Compliance / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D010358:Patient Participation; D015995:Prevalence; D011320:Primary Health Care / Q000592:standards / Q000639:trends; D011634:Public Health; D012307:Risk Factors; D013781:Texas / Q000453:epidemiology; D014768:Virginia / Q000453:epidemiology
chemical_list: D004837:Epinephrine
keywords: Anaphylaxis; Community medicine; Epinephrine; Patient management; Severe allergic reaction; Symptom recognition