title: Allergy in Irish adults: a survey of referrals and outcomes at a major centre.
abstract: BACKGROUND
  There is an increasing demand for specialist public allergy services across Ireland. Little data exist on the patterns of allergic disease in Irish adults. The limited resources available require innovative strategies to ensure quality care delivery.
  
  
  OBJECTIVE
  This study aimed to review the types of allergy referrals and diagnostic outcomes at a major Irish centre, and to establish an efficient method of communication with non-specialist practitioners.
  
  
  METHODS
  Demographic data, referral characteristics and diagnostic outcomes from one hundred consecutive new allergy referrals were identified. Additionally, communications to a pilot email service were reviewed over a 12-month period and user satisfaction assessed.
  
  
  RESULTS
  Requests for the investigation of food allergy accounted for 71% of referrals. Despite this, the main diagnostic outcome in this cohort was a non-allergic condition, chronic spontaneous urticaria (56%). immunoglobulin E (IgE)-mediated food allergy was definitively diagnosed in only 9% of patients, with the majority of these presenting with anaphylaxis. The allergy advice email service received 43 requests for assistance over 12 months, mainly for help in the interpretation of an allergy clinical history. Feedback on the email service was universally positive.
  
  
  CONCLUSIONS
  The majority of patients in this cohort did not have IgE-mediated allergic disease. Increased awareness of the features that differentiate allergy from non-allergic conditions such as food intolerance or chronic spontaneous urticaria is required. The allergy advice email service should be developed further to play a key role in education and care delivery in partnership primary care.
authors.affiliation: Central Pathology Laboratory, Department of Immunology, St. James's Hospital, James Street, Dublin 8, Ireland, conlonn1@tcd.ie.
authors.forename: N P
authors.initials: NP
authors.lastname: Conlon
authors.forename: A
authors.initials: A
authors.lastname: Abramovitch
authors.forename: G
authors.initials: G
authors.lastname: Murray
authors.forename: A
authors.initials: A
authors.lastname: O'Hanrahan
authors.forename: D
authors.initials: D
authors.lastname: Wallace
authors.forename: K
authors.initials: K
authors.lastname: Holohan
authors.forename: N
authors.initials: N
authors.lastname: Cleary
authors.forename: C
authors.initials: C
authors.lastname: Feighery
authors.forename: C
authors.initials: C
authors.lastname: Lee-Brennan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003625:Data Collection; D005260:Female; D005512:Food Hypersensitivity / Q000453:epidemiology*; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology*; D007073:Immunoglobulin E / Q000276:immunology; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011320:Primary Health Care; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D014581:Urticaria / Q000453:epidemiology; D055815:Young Adult
chemical_list: D007073:Immunoglobulin E
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