title: Prescriptive appropriateness using inhalant and food allergen panels: a comparison between General Practitioners' and Allergists' prescription in Genoa (Italy).
abstract: Background.Prescriptive appropriateness is an actual claim in healthcare, and it also concerns in vitro tests used in the allergy work-up, such as the serum allergen-specific IgE (sIgE) assay. In the Liguria Region, two panels were defined (for inhaled and food allergens) including 12 allergens. Their composition changed over time.Objectives.The aims of the present retrospective study were: i) to evaluate the percentage of positive tests, and ii) to compare the findings of sIgE assay on the basis of the general practictioners' (GPs) or specialist' prescription, considering both the old panels and the new panels.Methods.This retrospective study considered a population of adult patients, which consisted of 2368 subjects (68% females; mean age 50 years; age range: 10-103 years). Serum sIgE were measured by ImmunoCap system.Results.The percentages of positive tests were very low for food allergens and low for inhaled ones (ranging between 5% to 35%). There was change of prevalent prescriptor with new panels.Conclusions.This study underlines the relevance of prescriptive appropriateness in the allergy work-up. The sIgE assay should be limited to those allergens that have a clinical relevance, based on clinical history.
authors.affiliation: Internal Medicine Department, IRCCS-AOU San Martino - IST, Largo R. Benzi 10, 16132 Genoa, Italy. E-mail: gio.cip@libero.it.
authors.forename: G
authors.initials: G
authors.lastname: Ciprandi
authors.affiliation: Laboratory Medicine, IRCCS-AOU San Martino - IST, Genoa, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Comite
authors.affiliation: Laboratory Medicine, IRCCS-AOU San Martino - IST, Genoa, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Ferrero
authors.affiliation: Laboratory Medicine, IRCCS-AOU San Martino - IST, Genoa, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Montaruli
authors.affiliation: Laboratory Medicine, IRCCS-AOU San Martino - IST, Genoa, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Mussap
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000485:Allergens / Q000008:administration & dosage* / Q000276:immunology; D000072223:Allergists / Q000639:trends*; D015415:Biomarkers / Q000097:blood; D002648:Child; D011307:Drug Prescriptions; D005260:Female; D005512:Food Hypersensitivity / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D058005:General Practitioners / Q000639:trends*; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D019570:Inhalation Exposure; D007428:Intradermal Tests / Q000639:trends*; D007558:Italy; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000639:trends*; D011237:Predictive Value of Tests; D012130:Respiratory Hypersensitivity / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000485:Allergens; D015415:Biomarkers; D007073:Immunoglobulin E
keywords: allergen-specific IgE; appropriateness; general practitionnaire; panels; prescription; serum; specialist